HomeMy WebLinkAboutMortgage_Gardnere� rt�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
+ = FOR DEDUCTION FROM ASSESSED VALUATION
4 y State Form a37o9 (fta � io-Op
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� Prescribed by Department of Local Govemmem Finance
INSTRUCTIONS:
To be filed in person or by mail wifh the County Auditor o/ the county where the property is located. �� ��
Filing Dates: 1) Real P�operty: During the 12 months be%re May 11 0/ the year the deduction is to be ef/e 2002
2) Mobile Homes assessed under IC E1.1-7: Between January 15 and March 31 0( theyear the deduction, is to 6e effective.
See reverse srde (or additional insf�uctions and qualifications.
Applicant
Distrid
or contract
Assessed value of real property as of
March 1, current year
restnctions or�reverse
If no, what is his / her exact share of interest?
GIBSON COUNTy
Key number / legal description I Record number
0 0►- o o r a b-� o Page number
Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or e
March 1, wrrent year owneR ❑ Yes ❑ No
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If owned with someone other than spouse, indicate with whom.
�6 -ao - o��oo - o00 •ia.c -Qo/
If name on record is different lhan that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home QC fr1.1-�
of mortgagee or contrad seller
Address of morigagee or contract seller (number and st2et, city, state, ZIP
assignee or other owner or holder of mortgage
of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? I What Taxing District? Has this deduction been requested on
county in Indiana? property for current year? � Yes� No
COUNTY AUDITOR
Deduclion approved in fhe amount of:
20 � 20 �_ 20 �� 20
s p
Sign ure „4 � �� County Au�
20
20
Date
20
Q� �
P �
certiy under the penalry of perjury that the above and foregoing information is true and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
(owners /ull nan
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:ntaddress aF
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Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ofauthorized person