HomeMy WebLinkAboutMortgage_Knapp F?_: STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS T'W Year
�r % FOR DEDUCTION FROM ASSESSED VALUATION
state Form 437og(R11/6-0g
Prescribed by Department of)Local Government Finance
DEC 2etOlt
INSTRUCTIONS: .
Form filed With:
To be fled in person or by mail with the CounlyAuditor 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 t. ....,'....,'We...unty Auditor
2)Mobile/Man ctured Homes not assessed as Real Property Must Re during the twelve(12)month- neer
before/ f
year the deduction is sought GIBSON COUN A•iMb:Sjprd er
See reverse side for additional instructions and qualifications.
(owner or contact buyg see restrictions on reverse side) ,, . �J/���//)
Taxing District, E..r�J number/legal description /� /Y / r Record number Page number
11/11-4104-' a.4-19- / 9 - 3oo - ooa. _390 - 0AS 2-ol � L( Y9 '7
Assessed vale ofreal prperty as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1:anew year March 1.cement year date of application legal or equitable owner?
X60 vow 0 Yes 0 N
If no,what Is his/her exact share of interest? If owned with someone other than clan,r ,indicate with whom
If name on record is different than that of applicant.indicate below Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
n n Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller/!< 7 v are v —
Address of mortgagee or contract seller(number and street,city state,and ZIP code) -//
Name of assignee or odor owner or holder of mortgage Drawer N O,faassignee(number and stree4 city.state,end ZIP code) f1`�/
r I Sc J 19 -3 —/o 1,o tic Card NO. / [ •• _
.............
Does applicant own property in any other If yes,what county? - What Taxing C
county in Irdana?
❑ yes ❑ No _ .._
COUNTY AUDITOR
Deduction approved in the arrount of
20 20 20 20 20 20_ 20
signs of Canty Auditor \ County Data(month,day,year)
I I We rtify under the penalty oof perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
A"-- own Ico ct buyer of the aforementioned property on date application is filed. .
Sig Ml e) Date(month,day,year)
y F ant address of app t(number and street,aiy,state,and ZIP code)
al) Lai with S. I Fl grcnufl. V7(sY&
Person authored 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,city,state,and ZIP code)