HomeMy WebLinkAboutMortgage_Reinbrecht (6) • t�-. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coon Township Year ED
a FOR DEDUCTION FROM ASSESSED VALUATION p ,1 g
r' t1'• State DEDUCTION
43709 CT/6-09) 1.1 Y
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: NOV ]-Y-o••'1 7 with:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. I • County Auditor
2) Mobile/Manufactured Homes not att-ssed as Real Property Must file during the twelve(12)mo j-
before March 31 of each year the deduction is sought •, :jTf is County Recorder
See reverse side for additional instructions and qualifications. G I BSO N 'FOB • - • • • -
A ' Di( or contract buyer see restrrbonsan si7e)Ed Y O
Taieg District Key numbig/
legal desaipption Record number Page number
a (o-/ q_ 31 -go o - coo. IPg6, - 0021 ; 013 2,69.5_3
Assessed value cites!property as of Mortgage/Contact indebtedness unpaid as of Mortgage
March 1,aimrt year March 1,arrmnt e of a /Contact troebteMess unpaid as of Is the applicant e the sole
op—1 /� date o(appfoation legal a equitable torte(!
f /. (p Q 0 I ❑ Yes ❑ No
If no,what Is his/her exact share of interest? If owned with someone other than
spouse,Imdipte with whom
If name on record is different than that of applicant.indicate below
Is the Property in
question:Annually Assessed
Rear _ ...r. -
Name of mortgagee or contact seller _
7 T� l/J7 .......
Address of mortgagee or contract set (nu rand steer. state,and ZIP e� LI'1\�'Cl' 'NO•••1•'rr'.�.. ..
Name of assignee or other owner or holder of mortgage
Card NO. .cQ 53........•
•
Address of assignee(number and street city,state,and ZIP code) 4 1917)6900 , /
Does applicant own property in any other If yes,what county? . What Taxing District? ,its(reduction teen requested on property
county in Indiana? for anent
❑ Yes ❑ No I I Yeah ❑ Yes ❑ No
1
COUNTY AUDITOR I
Deduction approved in the anoint of: I
20_ 20 20 20 20 X20 20_
S9na>li atii'(c .4 r County Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Date(month,day,year)
ufl revent address of ppfcant(number and street state,and LP`�)
7n9F. eetnht„ta tit!_ IIa.tbsbf, s� y763f
Person authorized by duty executed Po of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code)