HomeMy WebLinkAboutMortgage_Nossett (2).+"•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township r
,-i � 4 FOR DEDUCTION FROM ASSESSED VALUATION
Stata Fortn 43709 (Ri l/ 6-09)
•• �' PreSCnDed by OepaNnent of Loral Govemment Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. Fwm ned vrith:
Filing Dates: 7) Real Property: Mus( be mmpleted and dated in the calendar yea�lor which the deduction is sought Coun Auditor
Must be filed wifh the CountyAudifor or Counry Recorder of 1he counry where 1he property is located ❑ n'
on or be(ore January 5 07 fhe immediatety succeeding calendar year. ❑ County Recorder
2) Mobi/e /Manu7actured Homes not assessed as Real Properfy: Must file with fhe CounryAudi(or o/ fhe
county where the property is Ixafetl dunng the twelve (72J mon(hs be7ore March 37 07 eacb year the
deduction is soughi.
See ieverse side for addifional inttmcfions and qualifications.
Applica^t (owner or conbact buyer - see resfrictloris on reverse side)
Jeffrey Duane Nossett and JG. ' }{V �
TaringDisUict Keynumber/IegalGescription R number Pagenumber
Columbia 2614-19-104-000.960-OO6IPT NW 7/4 19-2-8 0� �
AcsesseC vdue of real properry as ot Mortgage I ConoaG in0ebtedness unpaid as of Mortgage / Contrad indebteEnass unpak as of Is �he applicant Na sde
MarU� 1, aurentyear Marc� 1, wrten; year date of app6cation legal or equi'able owner7
82417.00 ❑� Yes ❑ No
If no, whai is his / her exaG share ot interest? It ownetl wiN someone oNer Nan spouse, indirate vriN whom
joint tenants with full rights of survivorship Jamie Lynn Hutchinson
If name on record is EiRerent ihan Nat oi aD0��4 ��diwta bebw: Is Iha pmperty in Ques6on: MnuaOy AssesseE
❑� Real Property ❑ MnuallyAssessed
Mobile Home (IC G7.1-7)
Name of mortga9ee m contraa se0er
German American Bank
Address of mwtgagee or conVact seDer (number antl s(reet, uty, sfa(e, antl ZIP co0e)
771 Main Street Jasper IN 47547
Name of assgnee or other owner or hdaer of rtartgage
AtlCress of assignee (namber antl street dry. sta;e. arM ZIP code)
Does appliwnt own pmperty in any other If yes. what counry? What Tadng �isVict? Has Nis deduction bren requested on property
counry in InOiana? for curtent year9
❑ Yes ❑� No ❑ Yes O No
COUNTYAUDROR
Deduction apP�vM in Ihe amount of: '
20 20 _ 20 _ 20 20 20 20 _
Signature ol County Autlitor County Date (monN, tlay, yea�
I/ We certify under the penalty of perjury that �he above and foregoing infortna6on is W e and cortect and Ihat Ne applicant is a resident of Indiana and
owner I conVact buyer of the atoremenlioned property on dale apD�iqtion is filed.
SignaNre (owner na e Data pranN, day, yee�
10/1Q'12
F W resitlent C 1 i nt (numEer and SLeet, crty, stale, aM ZIP cotle)
1857 S 0 O nd Ciry IN 47660
Person a - eC Ey Cuty executeC Power ol Attomey w by IC G7.142-07 Data (mw+N, tlay, yea�
Address of authorizeC persan (number a`M sbaet. city, sfate, and Z/P code)
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