HomeMy WebLinkAboutMortgage_Perry (6)...�'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES -�Cotm 7 ip Year
�4, .: FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (RB I 2-07)
�' - � Presrnbed by Department of Local Govemmeni Finance
Mark
INSTRUCTIONS:
To be filed in person oi by ma� wdh the County Audifor o/ fhe county where fAe piopeRy is located. � �
Filing Dates: 7) Real Property: Dunng fhe 72 months before June 17 0/ the yesr the deduc6on is to be eRec6ve.�i �7C� �
2J Mobile Homes assessed under IC 64.7-7: Befween January 75 end March 2 o/the year fhe d�uclionQy to be 6ve.
See reverse side for additional insWctions arrd quali(cafioru. GIBSON COUNTY AUDITOR
Applicam (o�oper w cpnvad buyei - see re�yYAcfions (rr v rse sitle)
number /
Pssessed value of real qoperty as of March 1,
wtiat
m
Vial d eppiicar0. intlin�e below:
Name of rtwtlgagee or conUacl seller - -
A���=o P�Y ����c� ���'
Nama of a �� J 6� Y y
Address o'�
counry m r ._._.
❑ Yes ❑ No
Deduction appioved in the amoun
20 �% 2b
SignaW re of County AutlMr
20 _
�
ZlPCOde)
20
iess unpaid as df March 1,
ipsq
If owned wilh someone oll
What Texing Disirict7
20
I Rem� � I Page number
O� � �i�
Is the appGpnt the sde legal a equita e awner
❑ Yes ❑ No
spouse, indicale wi�h whom.
1I�s,the property in QuesGm:
L�eal Prooertv ❑ Mobile Home OC G7
20
o�
requested on poperty
❑Yes ❑ No
20 _
I/ We cer6fy under lhe penalry of perjury that ihe above and fwegoing informafion is true and corteU and Mat the applicants was I were a residenl of
Indiana an �iner ot tlie aforementioned prop n March 7, 20
17iWre ( n slyll name) . , Dale (monfh. tleY. Y��)
appicaM (numb end streel. c�tate. a LP code)
i� �, p�
iy exeated Power W Altomey a by IC &1.��67
of author¢ed person (number erM sheeG dty. s(ate, eM ZIP cotle)
Dafe (mmN, tlay, yea�