HomeMy WebLinkAboutMortgage_Krieg�E���4 STATEMENT OF MORTGAGE OR CONTRACT
ar �_. .: �e
�r � INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
" ' VALUATION State Form 43709 (1-90) Prescribed by the
' � e• '� State Board of Tax Commissioners
� �,
Towns
11
Instructions for filing:
To be filed in person or by mail with the County Auditor of the county where the AUG 1 51gs� '
property is located during the 12 months before May 11 of the year the deduction
is to be effective. See reverse for additional instructions and qualifications.
GIBSON OU TY AUDITOR
�pplicant (Owner or cont c yer - see restrictjons o�reyerse) ��'/ ��g. �s�
1� 1�.�-1 / L/ 'C n� o �, -3—� �_
Taxitw District
Number/Legal
—l'�r /S� Q
Record No.-
Assessed value of real property as Mortgage/Contract Indebtedness unpai
of March 1, current year as of March 1, current year.
� 0 � .
If no, what is his/her exact share or interest? � If owned wit
indicate witY
If name on record is different than that of applicant, indicate below:
of mortgagee or contract seller
Address of mortgagee or contract seller
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee
Year
/ /
'age No. J U Q�
c'--•"�-�nnlicant the sole legal or
�-_.,_.io
Na �"1 orNe�
�/l��a
bH ��,�a
�
Does applicant own real property If yes, what county? What Taxin� District? Has this deduction been
in any other county in Indiana? . requested on property for current
year? O yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19� 19��� � 19_,�,�SJ �
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of Board of ReJiew I Date�
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I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
�s waslwere a resident of Indiana and owner of the aforementioned property on March 1, 19 .
Signature ers full name) Person authorized by duly executed Power of Attorney or
— �� �% /}/ •- - by IC 6-1.1-12-.07).
II Resident f�'dre�s of Aplicant Q I Address of Authorized Person
r'J� nI. MR�o[ ��d � � �.,..