HomeMy WebLinkAboutMortgage_Gregoryi4a `�'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
+\i�� FOR DEDUCTION FROM ASSESSED VALUATION
`'. -e' Siate Form 43709 (R6 / S-06) , . .
� �«: ,
Presaibed by Deparimen� of Loql Govemmenl Pinance
INSTRUCTIONS: �
To be filed in pe�son or by mail with the County Audrtor o/ the county whe�e the propeRy is located.
Filing Dates: 1J Real Property.� Dunng the 12 months belore dune 11 of the year the deduction is to b��ctive5 ��� l
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 of the ye�-ayr ,t�,he deduction is to be eHective.
See reverse side fo� additional insfructions and qualifications. O'�a� ��
^ GIBSON COUNTY AUDITOR
Applicant(ownerorcontract ye -see
Taxing Distrid
. C� -
Assessed value of e I property as of
March 1, wrrent ye r
If no, what is his / her exact share of interest?
If name on record is different than
of mortgagee or contract seller
side)
number / legal
number
o��o -a'b � `�,�� ='aL�•D ` /3l�
MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year , ownerl ❑ Yes ❑ No
.. 3 0�
If owned with someone other lhan spouse, indicate with whom.
indicate below:
Addressof mortgagee or contract seiler (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does appliwnt own property in any
county in Indiana?
Deduction approved in the amount
zo n x i zo
,P � P
Signature
If yes, what county? I What Taxing Dislrid7
CO�,-'' T' 1
I '�J C��� � �.9�
����� ��, -
❑ Real Propsty ❑ Modle Hane OC 61.
property for wrtent
zo
zo
iestee on
Yes� No
We certify under the penalty of perjury that the ,,.e and foregoing infortnation is true and corred and that the applicants was / were
residenl of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
person