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HomeMy WebLinkAboutMortgage_Knapp (2)� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year �. ,«. ! state Form a3709 (R5 / a-03) ' . �� . , ; - � } � . _ ' � . . • � � PresaiEed by Department of Local Govemment Finance ���? E� � j' f� u""1 i 1i Sl 3L1 1LJ JAJ� INSTRUCTIONS: MqY FiIJ M�� To be �led in person or by mail with the County Auditor o/ the county where the property is located. cuu Filing Dates: 1) Real Property:� Dunng the 12 months be(ore Mey 11 0/ fhe year the deduction is to be e(/ective. /� �2) Mo6ile Homes assessed unde� IC 6-7.1-7: Between January 15 and March 2 o/the �ear the deduction%is to be ef(ec vG e. /`J�-�^�-✓14;J ;'�-c^-i��' See reverse side for additional instructions and qualifications. ' G:8Sr3i! COUtv7Y �,����17C" . Applicant (own or contract buyer - s restrictions on re erse side) Tacing Districf . Key number / legal d s ption Record number � I_-�.� -I"11 Q� � D' lQ s C',�,hO Page number �� � w� ' t.l l(, 0 7 v Assessed value of real property as of MoAgage / ContreU indebtedness unpaid as of Is the applicant the sole legal or equitable March 1, current year March 1, current yeer ownef? ❑ Yes ❑ No If no, what is his / her exact 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 Home (IC 61.1-� �ame of mortgagee or conlrad seiler � i Address of mortgagee or contract seller (number and street, city, state. ZIP � Name of assignee or other owner or holder of mortgage Address of assignee (number and street, city, slate, Z!P code) . Does applicant own property in any other I If yes. s:fiat county? I l^lhat Taxing District? Has this dedudion been requested on county in Indiana? � property for current year?� Yes❑ No � COUNTY AUDITOR Deduction approved in the amount of: zo �_ za 2o za � zo � zo 0 9 20 � P P Signature County Auditor Date / We ertify under the penalty of perjury that lhe above and foregoing information is true and corred and that ihe applicants was / were re� ent of Indiana and owner of the aforemen�ioned property on March 1, 20 ture (owners (ull name) , Person authorized by duly executed Power of Attomey � n or by IC 6-1.1-72-.07 I!� II r sident ad ress o plicant Address of aulhorized person 3 o S �rR,cs�