HomeMy WebLinkAboutMortgage_Fordeck�� .k STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�• = FOR DEDUCTION FROM ASSESSED VALUATION
\: ! �a�e Form 43709 (R6 / 5-06)
Presoihed by Oeparimenl of Loml Govemment Finaxe
�•
INSTRUCTIONS:
To be (led in person o� by mail wrth the County Audito� of the counfy where the property is located.
Filing Dates: 1) Real Property: Dunng lhe 12 months before June 11 olthe year lhe deduction is fo be eK�t�. 2 4 ZQQ]
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 01 fhe year the deduction is to be e(fective.
See reverse side for additional instiucG'ons and qualifications. �'/j�G ��
GIBSON COUNTY Al1DITClR
or cont2ct buyer - see iestrrctions on 2ve�se
''f�_/ � �"�° ' `
Assessed value oi real property as of
March 1, current year
no,
share of
/legaldescription
ab - ao -,2 8 -doO-OoD,
MoRgage / Contract indeb
March 1, curtent year
�J�i � ��
as
number �OD 7
imber 3 � n z
b�-/
Is the applicant the sole�legal or
owner? � Yes ❑ No
If owned with someone other than spouse, indicate with whom.
I( name on record is different than that of applicant, indicate below:
ie oi mortgagee or conVact seller
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Address oi mortgagee or contract selter (number and street, city, state,
Name oi assignee or other owner or
Does applicant own
counry in Indiana?
Deduction approvedin
�
�
ZIP code)
s the property in quesUOn:
❑ Real Property � Mob�e Home QC 61.1-7)
y in any other If yes, what county? What Taxinc �j
Drawcr i1'O.. �.(.
� Card i\'O. ....�I$3
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COUNTY AUDITOR � � � � � "' •
amount oi: � �� �
, ,/
20 �� 20 20
P
County Auditor
20
20
lon
� No
We certify under the penalry oT perjury that the above and toregoing infortnatlon is We and cortect and that the applicants was / were
'esident of Indiana and owner of the aforementioned property on March t, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-�2-.07
resident address of applicant � Address of authorized person
813�/ E 9� S ��bel�/p�,_