HomeMy WebLinkAboutMortgage_Krohe!�� y STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS i
s' s FOR DEDUCTION FROM ASSESSED VALUATION � Year
�«•v StateFwm43709 (R6/S-06) NOV 0 8 2�06
Presaibed by Departmenl of Local GwemrtreM Finance
INSTRUCTIONS: " � F��rk
To be fi/ed in person or by mail wrth the CountyAuditor of fhe county where the p�opeRy is Iocated.GIBSON COUNTY AUDITOR
Filing Dates: i) Real P�operty: Du�ng the 12 months befo2 ,lune if o/ the year the deductlon is to be elfective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deducG'on is to be effective.
See �everse side for additional instructions and qualifications.
Applicant (o � or contract buyer - se strictlons on reverse side)
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Taxing Distrid Key number / legal description Record number �
/� / o?G :d0 -0?7 /ll0-`,�yX��- oS��b/ _
( /,(L�' , /�y � �/_ � yy-�„(�i� _ � Page number
7L� :Q�TU'�' 6.E,CJ /
Assessed value of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owneR ❑ Yes ❑ No
� 4�C.LJ
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is lhe property in question:
❑ Real Property ❑ Mobile Horne (IC 61.1-�
�me of mortgagee or conVact seller ,
Address of mortgagee or conVact seller (num d street, dty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sbeet, city, state, ZIP code) � ,
Does applicant own property in any other If yes, what county? Dr1�Ver �T�..�!.� .� . G�.S / been requested on
county in Indiana? L_ yeaf? � YesO No
Card NO . .....................
COUNI
Deduction approved in the amount of:
20 � 20 Q��� II 20 0� 20 20 20 20
.P P P
Signature County AudRor Dale
�/ We certify under the penalty of peryury that the above and foregoing infortnation is true and corred and lhat the applicants was / were
a resident of Indiana and owner of lhe aforementioned property on March 1, 20
Si n lure (owner (ull e) Person authorized by duly executed Power of Attomey
/ ���� or by IC 6-1 J-12-.07
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Full resident address of applicant Address of authorized person