HomeMy WebLinkAboutMortgage_Snyder�
�.«., .
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION ,
Stale Fwm 43709 (RS I 4-03)
P2scn�ed by Oepartment of Local Govemment Finance
����
� ? i (Y '' s.�'3
� i!
INSTRUCTIONS: OCT �i1e4�(�5
To 6e filed in person or by mail with the County Auditor of the county where the property is /ocated.
Filing Dates: i) Real Property: During the 12 months be%re May 11 0/ the year the deduction is to be eflective.
� � 2) Mobile Homes assessed under IC 6-1.1 J: Between January 15 and March 2 0/ the year th� chav� be eNective.
Seereverse side for additional instructions and quali�cations. GIBSON C� TY A DITOR
Applicant (owner or nt ct buyer- see �estri ons on erse side)
Taxing Distrid , Key number / leg description Record number �
D Q f�Qr S�� Page number /�
" C� [ J
Assessed value of real property as of Mortgage / Contraci indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owne(? ❑ Yes ❑ No
if no, what is his / her exact share oi inierest? I owned with someone olher 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 Home�QC 61.1-�
�ime of mortgagee or contract seller �� �
Address of mortgagee or contrect seller (number and street, cify, stafe, ZIP
PJame of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does appticant own propeRy in any olher If yes, what counry? Whal Taxing Distrid? Has this deduction been requested on
county in Indiana? property for current year?� Yes❑ No
COUNTY AUDITOR
Deduction approved in the'amount of:
20 �� 20 20 � 20 20 20 20
� � P
Signature County Auditor Date
�/ We ify under the penal perju that the above and toregoing information is true and corred and that the applicants was / were
� a resi nt of I�' and of t ementioned property on March 1, 20
Sig tur ow Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
F s addres of a nt Address of authorizzd person
�