HomeMy WebLinkAboutMortgage_Knowles atSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS -County- "IT'• liiownsfiip Year
FOR DEDUCTION FROM ASSESSED VALUATION yam` 11 t'
State Form 43709(R11/6-09) q 1 �:
Prescribed by Department of Local Government Finance Fy1 ,�r�
INSTRUCTIONS: OCT 2letU14
Form filed with:
To be filed in person or by mad with the County Auditor or County Recorder of the county where the property is located. 4'
Fling Dates: 1) Real Property.Must file during the year for which the deduction is sought • 01 .County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)month P.
before March31 of each year the deduction is sought GIBBON cow'! rder
-See reverse side for additional instructions and qualifications.
Apprmn(owner or contract buyer-see restrictions reverse side)
ATaxing District Key number/legal d ption Record number Page number
alp -l7 -0a - ape, - ovj, 7 / 7 _ 0 J. ( 2,O ( L( 14 YI7
Assessed rata real property afht Mortgage/Contract indebtedness unpaid as of Mortgage I Contract Indebtedness unpaid as of Is the applicant the sole
Mann 1;current year V March 1,current year date of uapp�tion legal or equitable owner?
rj Q O•D ❑ Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone dher than spouse,Indicate with whom
If name on record is different than that of applicant,Indicate below. Is the property in question:Annually Assessed
❑Real Properly ❑AnnuallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract setter if n
Address of mortgagee or contract seller(number and street,city,state,and ZZL—P code)
Name of assignee or odmer owner or holder of mortgage
Add of assignee(number and sheet,ray,state,and ZIP code)
PT NE a - 3 _ j lo .pO 4c — -
Does applicant own property in any other If yes,what county? • What Taring I-
county in Indiana? -
❑ Yes ❑ No _
COUNTY AUDITOR Drawer NO. II _
Deduction approved In the amount of:
20 20 20 20 •Card NiO. 44111 '7
g rr..�7 . .Couny roc ytnr Qy�C„of County Audlid
I 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
oppwwyr///ppp�4ppp�r I contract buyer of the aforementioned property on date application is filed.
XX Sig[/rc.dute(owner's MI Date(rnorth, year)
/
`,/l �I LLjj/ 10/02/loaf .
,A\/ FFW resident address/of (number street ay,state,and ZIP code�� �j _
78/o Gc) SAO S ',use)/�t" y .--U/ Ltf/66 S
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Data(north,day,year)
Address of authorized person (number and street city,state,and ZIP code) .