HomeMy WebLinkAboutMortgage_Knight`°�'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
-° FOR DEDUCTION FROM ASSESSED VALUATION ount Township Year
S ��� / Slate Fwm 43709 (R4! 10-Ot) � � ?,
� µ� U
Prescribed by Department of Local Govemment Finance �
INSTRUCTIONS: � � File Mar�
To be filed in person or by mail wifh the County Audifor ol the county where the property is locate� ��� �r'�l
Filing Dates: 1) Real Property: Dwing the 12 months be%ie May 11 0/ the year the deduction is t�� e��r�ve-J
2) Mobile Homes assessed under IC 6-1.1-7: 8ehveen January 15 and Maich 31 0/ the ye�,tFlhK d�d� t{qq,j� to 6e eHective.
See reverse side loradditional insLuctions and quali�cations. �� Ll1U
Appticant (owner or contract b ye�- see restrictions on revers ide
ing Dis 'd Key number / legal d
c�l J � 60� —O,
Assessed value oi real properiy as of Mortgage / Contrad
March 1, current year March 1, cunent yea
If no, what is his / her exad share of interest?
/ ' ` ciasou c
ion Record number
78 QO Page number
�dness unpaid as of Is the appli
ownef?
v AUD�TGF .
u
Ithe sole legal or equitable
❑ Yes ❑ No
OV� I
If owned with someone other lhan spouse, indicate wilh whom.
If name on record is different than that of applicant, indicate betow:
Iame of mortgagee or contract seller �
Address of mortgagee or contrad seller (number and stre f, city, state, ZIP
Name of assignee or other owner or holder of mortgage
(num6er and street, city, sfate, ZIP code)
Does applicant own property in any other I If yes, what county? What Taxing District?
county in Indiana?
zo
Signature
approved in the amouni of:
200�
COUNTY AUDITOR
2005 20Qf� 20�
�
County Auditor
s the propeRy
❑ Real Property ❑ Mobile Home QC 61.1-n
� ��i
Has this deduclion been requested on
property for curtent yea(.� � Yes ❑ No
20 o y_ 20 0'
P
Dale
/ We certify under the penalry of perjury lhat the above and foregoing infortnation is true and correct and thal the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
executed Power of Attomey
or by IC 6-1.1-12-.07
II resident address of adplicant ' Address of authonzed person
� 3��} �� u D� Pru,►��� .��(