HomeMy WebLinkAboutMortgage_Snipes (2) „,„..r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year I
FOR DEDUCTION FROM ASSESSED VALUATION
it t; State Form 43709(R11/6-09)
Prescribed by Department of Lod Government Finance
II
INSTRUCTIONS: 1I
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is Iocated.M.AY it
Filing Dates: 1) Real Properly.Must file during the year for which the deduction is sought uniy Audtor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months
before March 31 of each year the deduction is sought - , 47 • r• •emder
See reverse side for additional instructions and qualifications. GIBBON Cn11NTy AUDITOR
AppTxanl(ownermaln seem was side) 4”
Taxi . DDii tsbiot Key en er/legal description Record number Page number
., A _ . %. €1L ; • — n.. - 1111.8,_ ari"- ._ x013 7A-
2 vahie of real property as of Mortgage/Contract indeb=.ness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the asp/sant the sole
tu • 1,arrest year March 1,ament year date of application legal Q( owner?
Vii CC el ❑ No
If no,what is his I her exact share of interest? l )) if owned with someone other than spouse,indicate with whom
If name on record is different than that of appliicant.indicate below. Is property in question:Annually Assessed
eel Pmperty ❑Annually Assessed
Mobde Home(IC 61.1-T)
of mortgagee or contract seller
tiff s �aka
Address mortgagee can seller(sum er and street ray.state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city.state,and ZIP code)
Does applicant own property in any other If yes,what county? • What Taxing District? Has this deduction been on property . -
county in Indiana? �l�11'� for current year?
❑ Yes Erlo Yes
❑ No
ll COUNTY AUDITOR I-
Deduction approved In the amount of
20 20 20 20 20 20 20
Signore of County Auditor County bra I Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true am D )Y�r i`r -4--em of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
a ), ear •Q/jof sppluaan (number and sbee4 state,and a � —:Sir of Attorney or by lC6 l � I •`-'r- 179 � �.••••. .•Person IVUUi••
Address of authorized person (number and street city,state,and ZIP code)