HomeMy WebLinkAboutMortgage_Maikranz (5)�i��A� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
's'�; FOR DEDUCTION FROM ASSESSED VALUATION
� -.;u. .y State Portn 437W (R6 / 5-06)
Presaibed by Department ol Loral Gwemment Finance
Coun Township Year
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INSTRUCTIONS: O C T 1 I ark
To be filed in pe�son or by mail with the County Audito� of fhe county where fhe property is located. �����
Filing Dates: 1) Real Property: During the 12 months before ,lune I f ol the year the deduction is to be elfective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the y� ��e4d duction is to 6e e8ective.
See �everse side fo� additional instructions and qualifications. � �/
GIBSON COUNTY AUCITOR
Applicant
Taxinp Dlstrid
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-see
Assessed value of real property as of
March 1, current year
what is his / her exad share of interest?
number /
—Do�a�
Record num8er D/
�O
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MoAgage / ContreG indebtedness unpaid as of Is ihe applicant the sole legal or equitable
March 1, current yea��n b� owne(? ❑ Yes � No
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If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
�me o1 moAgagee or contrad seller �� �
Address of mortgagee or conVad seller (number and street, city, state, ZIP
of assignee or other owner or holder of mortgage
of assignee (number and street, dty; state,
Dces applicant own property in any other I If yes, what couniy? What Taxing Dislrid?
county in Indiana? __ —
Deduction appro�
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Signature
Dra��'er NOc�C•u�.:.•'•a�r �
f AUDITOR
Card NO. :.
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P
County Auditor
Is the properiy in question:
❑ Real PropeAy ❑ Mobite Home pC 61.
Has this deduction been requested on
property for current yea(? � Yes ❑ No
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Dale
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We certify under the penalty of perjury that the above and foregoing information is true and correcf and that the applicants was / were
resideni of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power oi Attomey
or by IC 6-1.1-12-.07
Nlesiaent aaaress ot appucant �J Address of authorized person
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