HomeMy WebLinkAboutMortgage_SchuppSTATEMENT OF MORTGAGE OR CONTRACTINOEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
: w� ♦ State Form 43709 (RS / 4-03) . - � - . .
� PrescriEeE by Department of Local Govemment Finance �
INSTRUCTIONS: Fite Mar1c
To 6e filed rn person or by mail with the County Auditor o/ the county whe2 the property is located. A i' k 1! 2��6
Filing Dates: 1J Real Property: During the 12 months before May 11 0/ the year the deduction is to be elfective.
, 2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is fo be eNective.
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See reverse side for addifional instructions and qualifications. .
GIBSON C � TY DITOR �i�
(owner or contract 6uyer -
Taxing
on reverse side) „ �
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Key number
Q�
• O' _ �� _ Page number � K 7 � ,�
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Assessed value of real property as of MoAgage / ContraG indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, currenl year March 1, current year owneR ❑ Yes ❑ No
If no, what is his / her exact
name on record is different than lhat of appliwnt,
of mortgagee or contract
a y�od �- a- � ��0.�3��
If owned with someone other than spouse, indicale wilh whom.
�/ Is the properiy in question:
�-�0��`� �� �32ea1 PropeAy ❑ Mobile Home pC 61.1-�
Address of mortgagee or wntrad seller (number and street, city, state, ZIP �/! ��""� ---�_
a � �� --_
Name of assignee or other owner or holder of mortgage �� �_� � „
�� ` � .
Address of assignee (num6er and sfreet, city, state, ZIP code) O��
Does applicaM own property in any other If es, what coun � What Taxin DistncC? ���� on
Y tY �
county in Indiana? I properiy for current year?u Tca�l No
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Signature
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in the amount :
20 (1 20
COUNT-�'-AUDITOR
P�e � v-�� e ,
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rawer `*0.......
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� � ki-ard NO� / . � � % �'
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_ County Audi., 6 � _ � � a�
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We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20 -
�nature (owners (ull name) Person authorized by duly executed Power of Aftomey
��� �'• �GiCCt�� or by IC 6-1.1-12-.07
Full resident address of applican� �Address of aulhorized person