HomeMy WebLinkAboutMortgage_Knapp (6)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
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� PrescriEed by Department of Local Govemment Finance �� ' �
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wsrRUCnoNS: �AN (,'�o'n^a�
To 6e filed in person or by mail with the County Auditor of the county where the property is located. �
Filin Dates: 1 Real Pro e Durin the 12 months before Ma 11 0/ the /' �'
g ) p rty: g y year the deduction is to be effec6ve. �/�
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year fhe'deduction is4o be effective.
i� GIBSON G„'.
See reverse side lor additional instructions and qualifications. -�� �
Applicant (o or contract buyer - see estrictions on reverse side)
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Taxing Distrid Key number / legal description ' Record number �� 2
l�-��j�7�(, � (% —O��/���0 Pagenumber � � �
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Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is lhe applipnt the sole legal or equitable
March 1, curtent year March 1, cyrtent year owneR ❑ Yes ❑ No
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Ii no, what is his / her exad share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is dif(erent than Ihat ot applicant, indicate below: Is the property in question:
❑ Reat Property ❑ Mobile Home (IC G1.1-�
me of mortgagee or contrad seller
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Address of mortgagee or contract seller (number and street, city, sfate, ZIP
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Name of assignee or other owner or holder of mortgage
Address of assignee (number and sGeet, city, state, ZIP code)
Does applicanl own property in any other If yes, what county? What Taxing Disirid? Has this dedudion been requesled on
county in Indiana? property for wrrent yeaf?� Yes❑ No
, COUNTY AUDITOR
Deduction approved in the amount of:
20�_ 20 20 20 ' 20 D q 20 20
�' P � P
Signalure County Auditor Date
�/ We certiy under the penalty of perjury that the above and foregoing informalion is true and corred and ihat the applicants was / were
. resident of Indiana and owner of the atorementioned property on March 1, 20
Si nature (owners full name) Person authorized by duly executed Power of Attomey
� ` or by IC 6-1.1-12-.07
F II resident address of applicant Address of authorized person
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