HomeMy WebLinkAboutMortgage_Knight�
� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
s FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
�. J sraee Form a3709 (R5 � a-03)
�N�
� Presrnbetl Dy Depanment ot Local Govemment Finance
INS7RUCTIONS: � � File Mark
To be filed in person or by mail with the County Auditor of the county where the property is lo�c�t�.� a 20�5
Filing Dates: 1) Real Property: During the 12 months be%re May 11 0l the year the deductio effective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the deduction is to 6e eflective.
See reverse side for additional instructions and quali�cafions. �y�4`� �
r_�ciSON,C""NTY AUDITOR
Applicant (owner or contract r see 2strictions on reverse sid ) �
Taxing Distrid Key number / legal description Record number ^
J
O I I �/\/1� f�/ _ O� Page number � �
' � (JV /�o
Assessed value of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owner? ❑ Yes ❑ No
If no, whal is his / her exacl share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Hmie (IC 61.1-�
�me of mortgagee or contract seiler ' _
Address of mortgagee or contracl seller (number and sfreet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrfct? Has this dedudion been requested on
county in Indiana? property for current year?� Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 � 20 �i� 20 �� 20 �_ 20 20 20
� � �
Signature County Auditor Dale
i We certify under the penalty of perjury that the above and foregoing infortnation is true and corred and thal lhe applicants was / were
esident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners full name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
F I sident a dress of applicant dress of authorized person
i--