HomeMy WebLinkAboutMortgage_Stuckey (3)���� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�' �t` FOR DEDUCTION FROM ASSESSED VALUATION
3� State Fortn 43709 (R6 / S-06)
� Presvibed by Departmenl of Laal Gwemment Finance
INSTRUCTIONS: �
To be �led in person or by mail with the CountyAudito� ot the county where the property is located.
Filing Dates: i) Real Property: Dunng lhe 12 months before June 11 of fhe year the deductlon i��tq�h�eBebfve3
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 oi the yea� the deduction is to be eflective.
See reverse srde for additional instructions and qualifications. `�;Ij�� �� ��ry:
GIBSON GuUNT i AuDll'OR
(owner or contr,/ct buyer -
Distrid
��
Assessed value of real property as of
March 1, current year
If no, what is his / her exad share of interest?
If name on record is different than that
of mortgagee or contrad seller
side)
Key number
��a�-oc
MoAgage / Contrad ii
March 1, current year
indicate below:
Address of mortgagee or contrad seller (number and sheet, aty,
Name of assignee or other
Address of assignee (numl
Record number
I��/ I Page number
unpaid as of I Is the applicant the sole legal or
ownef? ❑ Yes ❑ No
If awned with someone other lhan spouse, indicate with whom.
Dces applicant own proper a O O ry (�� ��
counry in Indiana? � 6
��� �
Deduction approved in th� �`4`'�/
G��
20 ��
P
Signature
20 _ �� y��.,/�
r�p-�. / ��V
_ `� ir�a�a. o�
trid?
Is the property in question:
� Real Property ❑ Mobile Home
Has this dedudion been requested on
property for current yeaR � Yes� No
20
20
— i
certify under the penalty of perjury lhat the above and foregoing information is true and corred and that the applicants was / were
leni of Indiana and owner of the aforemenlioned property on March 1, 20
ire (owners (ull name) Person authorized by duly executed Power of Attomey
� R��Y or by IC 6-1.1-12-.W
ot authorized person