HomeMy WebLinkAboutMortgage_Gatton.+°^*� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
� FOR DEDUCTION FROM ASSESSED VALUATION
Sate Fartn 43709 (R8l 207)
�� � Pr¢smbeE by Department of Local Govemment Finance �
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I fi( �y�
iNSrRUCnoNS: �--�
To be filed in person w by mad with the CountyAuditor o! the county whe�e fhe pioperfy is brafed.
Fding Dates: i) Real Property: Dunng lhe 12 months befwe June 17 of the year lhe deduction is to be eflective. � U L q� ( ���; j
2) Mobiie Hanes assessed under IC 6-1.7-7: Befween January 15 and Ma2h 2 0l the year the deduttion is fo be e!/�c ve.
See reverse side for addifional inshuctions a�d qualifications. �� _
npq� unerormnrraewye.-seer� " o�qnreversesiee) 0 GIBSONCOUNTYAUDI7p�:
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Tad isirid Key number / legal tl ' n RemN w ef Pa e n ber
-�D- - �-�. �- � O �
�� o{ ��y ys p( �.�y� �, �¢r�( year Mw�qage / ContraG indeWetlness unpaid as oi March t, Is Ihe appGmnt Ihe sole legal w equitaHe ame(
wrren�Year /��'�+„ 7o aoa
a u� � � Yes ❑ No
If r�what is his / her eract share of interesl? If wmetl wMh someone olher Ihan spcwu. i�Wicate vri�h whom.
on record is di(ferent Ihan Ihal of applicarrt, iMirale below:
Name of mortgagee or conUact seller
Adtlress af rtrortgagee or
arM sheel. tity, stafe. and ZlPCOde)
hdder of mori9a9e
of assignee (number arM sfieet, city, slate,
Dces applicant own praperty in arry olher
cauMy in Indaria7
❑ Yes ❑ No
apprwed in Ne amounl of:
,�3��
yes. what caunry?
20 _
VJhal Taxing Disiric
couNrrauorroR
20 20
Counry
Is Ihe propeM1y in questim:
❑ Real Pmpertv ❑ Mobile Home OC 6-1.
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G����' �����'
JS
�g- 30��'-
20
20
I! We certify under Ihe pen�ally of perjury ihal fhe above and foregoing infortnation is We and cortect and tliat Ihe app6c�nts was / were a resident of
Indiana and owner of Ne aforementioned property on March 7, 20 _
tlenl addr of applicaM (numbei and street. ctity. stafe.
'�%�C> �`. J��7S� ��/,�
Pason aulhorized by tluy acecvted Power of Attaney a by IC E
m0e)
2-.07
Date (monlh, day, yea�
Oate (murN, day, yea�
(number and street, cdy. slafe, and LP ootle)
i.� � ..