HomeMy WebLinkAboutMortgage_Lytle�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
S M� / State Form 43I09 (R5l 4-03)
� PreSaiDetl by DepaRment of Lotal Govemment Finance
�%
INSTRUCTIONS: Fil��
To be filed in person or 6y mail with the County Auditor of the county where [he property is located.
Filing Oates: 1J Real Property: During fhe 12 months be%re May 11 of the year the deduction is to �e�v
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year t�� Nd 2t2n (�tp„pe e((ective.
See 2verse side for additional ins[ructions and qualificafions. 1���
(owner
Tauing Oistrid
6uyer-see
Assessed value of real property
March 1, curtent year
GIBSON
Key num��r / legal description � Rewrd number
Page number / � (�3�
�o
� ooa-o�33 �-� 3 �
of MoAgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curre,,nt year �,�61 O O O. owner? ❑ Yes ❑ No
If no, what is his / her exact share of
If name on record is different than that of applicant, indicate betow:
of mortgagee or contrad seller
Address of mortgagee or contrad seller (number ahd sl2et, city,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does apptiwnt own property in any olher � If ves. wh=' -' —iy?
county in Indiana� -- "�
If owned with someone other than spouse, indicate with whom.
�� - /3 - �/- �a -�6�. .3.�/- 6fa�
What Taxing Distrid?
�
Drawer N0..9: S� (' 3�, L
()UNTY AUDITOR
Dec CardNO• •••��/'�'o;'�;;'
Zo. ��'ri�� �00 Zo�g_
�rReo�- I � �P -P �
County Auditor
Is the property in question:
❑ Real Properiy ❑ Mobile Home (IC 61.1-�
'la� 5
Has this dedudion been requesied on
property for curtent yea�?� Yes❑ No
zo � zo
�
Date
We certity under the penalty of peryury that the above and foregoing information is true and corred and that the applicants was / were
�ident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duty executed Power of Attorney
or by IC 6-1.1-12-.07
of authorized person