HomeMy WebLinkAboutMortgage_Kingsbury f:_,_'.
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
t! State Farm 43709(RU/6-09) $a
Presoibed by Department of Local Government Finar a [J I q '
INSTRUCTIONS: ��--Ii BB��flfl(( D
lb be filed in person or mail with the County Auditor or County Recorder of the county where the property � 2 0 14
Pe by ty N / P PerfY 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:Must file during the twelve(12)months
before March 31 of each year the deduction is sought - , . city = "-
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See reverse side for additional instructions and qualifications. CIBSON COUNTY AUDITOR
Applicant( ar or contract buyer- ins on reverse side)
I 7‘111:1-6t7
T�9 D' l Key number/legal description Record number Page number
/p7i.r �,ox/ afv -/P-36 - 3°0 -co ?... Coo /- oaf Record 3o8 `>I
Area
value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,anent year March 1,current year date of appfrm p legal or equitable owner?
/ 6p 000 ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than souse,indicate with whom
If name on record is different than that of applicant,indicate below Is the property in question:Annually Assessed
❑Real Property p Annually Assessed
• Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller •
Pic A u
Address of mortgagee or contract seller(number and street,c' state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Add f ignee(number and street ' ,state,and ZIP code)
mend �� °t Grit to ,yi t 7 -
minty applicant Indiana? property in any other If what county? What Taxing District? .—i for current deduction been requested on property
" ❑ Yes ❑ No ��SG/✓ Y� -n_Yes_❑ No
Kin/6 sxSte•ic
COUNTY AUDITOR gin d D/ t
/ /)/e 5i3u L'
Deduction approved in the amount of • 7--,92.3-14
Drawer NO..N--.?o84
20 20 20 20 20. l't=KItn4E FEbE/eN L
Card NOeiCEOlr vNloA/
Sgnahn ofir/� i'�'✓fr-r'C�t' Greenly
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I I We certify under the penalty of perjury that the above and foregoing information is true and correct anu u,a.
owner/contract buyer of the aforementioned property on date application is filed. . •
` / Sig fire(ov ens MI name) Date(month,day,year)
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II resident address applicant(number and street,city,state,and ZIP code)
10361 5. ?k c s4nt Rf,r- /-15.1---13 Sic.,et-I- /N y>63 9 Di ;0 Mille
Person authorized by duty 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)