HomeMy WebLinkAboutMortgage_Frantz.•,—"—'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count 7ownship Year
,�f� FOR DEDUCTION FROM ASSESSED VALUATION
s• Slale Fwm 43709 (Re / 2-07) � ,
�''y,. � Prescnbetl by Department of Local Govemment Finaxe A.J
�NSrRUCnorvs: DEC 2 9 �(�1&�a�c
To 6e �/ed in person or by mail wifh fhe CountyAudifor of the county where the p/operty is located. �
Filing Dates: 7J Real PropeRy: Dunng the 72 months be(ae June 17 o/the year fhe deduction is to be eflec6ve. ,(!��
2J Mobile Homes assessed under IC 64.1-7: Behveen January 75 end March 2 0/ the year the deduc�ffila,69�eIf�Fve.
See reverse side !w addiGonal instruc6ons and qualificafions. �/ v
GIBSON COUMTY AUDITOR
Appl� t(owner or mntrdd 6�yer - see resfncfims on reverse si0e) � � .
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i�urg Dislnct Key number I legal destnption Remid number Page numbar
a�-a-o-i.� ao�-000.a3 - o � �oo y�99
Assessed rdlue M real perty as oF Ma�ch 1, curtenl y�r Mortgage / Contrad iMebledness unpaid as of March 1, Is lhe applimnl ihe sde legal d equitade ovme/7
anrent year � ^. � �
� ❑Yes ❑ No
� whal is h¢ / her exaG share of intere;
�
If name on recard is diRerenl ihan Ihal of a{
Name of rtroHgagee or contracl seller '
�
Address of rtpM1gagee w mntraC sNler (nc
Name of assignee or dher ox�r or holder
Address of assiQnee (numberand sVeef. ci
�reef. tity, slate. ar�d ZIP codej
Dces applicanl own propeny in any other �If yea, what counry7
counry in Indiana?
❑ Yes ❑ No
Deduction apprwed in the amount of:
zo n 9 zo zo
VJhalTa�dng District?
spouse,
Is Ihe property in puesUon:
❑ Real Property ❑ Mobile Home (IC 61.1-7)
s Nis tletlutlion been requestatl on propeNy
airrenl yeaR
❑Yes ❑ No
COUNTY AU^'T^"
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Dra�ver NO,...� .
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P �ard��w� ...
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Sig�awre of Counry Autlilor 1 Cau� •�, � D �
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I I We certify under the pena�ty of perjury tliat the above and foregoing infortnation .� �.,e ana correct and Mat ihe applic�ants was ! were a resident of
Irdiana and owner of Ne atorementioned property on March 1, 20 �
K Signawr ( wne/s /NI nartre) Date (month. dey. yeeA
,
, . nsitlenladdress_oFa�icam(numberandstreet.c" stat�aMZlPOOde) n . n , ��� � _
of Atbmey or by IC 61.1-12-.07
of author¢ed person (number and sfreeC aty. state.
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