HomeMy WebLinkAboutMortgage_Schenk a, . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
"`' ;` FOR DEDUCTION FROM ASSESSED VALU-A'TION®r 1
'''V..c- State Fans 43709(R11/6-09) f"1 I p ' IL
Prescribed by Department of Local Government Finance j� H�-�!
Pile Mark
INSTRUCTIONS: OCT 3 0 1014 Fonn filed with:
To be filed in person or by mail with the County Auditor or County Recorder of the county where a property is located.
Filing Dates: 1) Real Property.Must file during the year for which the deduction is sought County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Musbfile during the.iwefeii2)months
before March 31 of each year the deduction is sought 1..1112MCV‘all.64 County Recorder
See reverse side for add al instructions and qualifications. GIBSON COUNTY AUDITOR
Approarit(owners /�_/��—' ��y�rtf�i (,(q
D. �•'l. �/O 4 S-�00 CVO,/ • COS O V ao 1 1/`e/�'•num
Assessed value&reed property as of Mortgage l Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the adoront the
Mania 1;a eat year March 1,tartan year data of application legal or equitable owner?
SOODa - ❑ Yes ❑ No
If no,what is his/her exact share of interest? / If owned with someone other than spouse,indicate with whom
If name on retard is dtferent than that of applicant.Indicate hetow- Is the property in question:Annually Assessed
['Real Property ❑Amorally Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagees contract seller \/+ Q
)8111-linCt Address of mortgagee or contract seller(number and street,city,sate,and ZIP code)~r (!/"' ' `•"� L
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,sate,and ZIP code)
Does applicant own property in any other If yes,what county? • what Taxing Di strict? Has this deduction been requested on property
county in Indiana? ❑ Yes ❑ No for anent year? ❑ Yes
❑ No
COUNTY AUDITOR
Deduction approved in the amount of: •
20 20 20 20 20 20 20
I I
Signabae of ..ry. . . • - / County Date(month,•- ,year)
4-/ . i /. _-4/If ■ _Ls Alf_s.11t:1_IL l - D-
I l ,e 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 I contract buyer of the aforementioned property on date application is filed.
lire) • • : .
‘...ddi:) Date(month,day,year)
/,/ y,sate,and LP mile)
Paso• authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,rip,state,and ZIP code)
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