HomeMy WebLinkAboutMortgage_Church'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi Year
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FOR DEDUCTION FROM ASSESSED VALUATION
s�ate Form a37oB (as � zo7)
�' � Presv3ed b� Depanment W Lacal Go�emmeM Finance
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�NSrnucrioNS: SEP 3'0��'�
To be !!ed in person o� by mad wRh the CountyAUditor o/ the courtty where the property is located.
Fding Dafes: 7) Real Property: Dunng the 12 monMs belore June 17 of the year fhe deduc6on rs to be eNective. ,�7�
2J Mobile Hanes assessed under IC bf. f-7: Behveen January 15 and Maich 2 of the year the deductigh'F.s�f
See2versesideloradditionalinsLudionsandqualifications. GIBSON COUNTY AUDITOR
nppKant (amer�wpY�a r- see resixvons m ass l
Y/
T' i'G ey numhet / legal desaig(jpn
o�
A�es.cd vWue real popaly as of 1, aareN year MoNgage
arteM ye
�`-��, whal is his / her �ad share of interest?
If reme m recad is diHerart �han thal of applican4 indiqte belva:
Nama of rtwNgagea or conUacl sellar
nmres: ar monyaqee « co�uae sdle. (numau arie mae� dry. sra�e.
Name of assi9nee a alher owner a hdder of rtiortgage
Address of assgnee (muMei and sGret crty. state. and LP mde)
Does epplicarn own praperty in ary other
counry in Indiana?
❑Yes �No
Deduction approved in Ne.amwnt nf� -
.-�
Sigreture
I/Wecer
Indiana ai
Fiecord number Fage rwm
_ I�F- �- a .GbO•3�3 p� /6 /
a indebtedness unpaid as or March 1, Is Ihe app6pnl lhe sde legal « eryititahle avneR
�i(/OO ❑ Yes ❑ No
If owned wiih sortieme alher Ihan spouu, indifate wifh whom.
If yes, what wun�
Dra���er NO. d. �-• • �•�O• •� �
.�
CardNO . .....................
w by IC
AdCress of aulMraed person (num6eraM streef, cdy, stafe. ard LP
Is Ihe property in question:
❑ Real Property O Mobile Hwne pC 61.1-7)
Has Uds dedudion been requested on pfoperty
for wrrent yraR
❑ Yes ❑ No
COUNTY AUDITOR
w Zo _ zo zo
co,,,,n o� p„�m, ear. r�d
� infwmation is We and ooReG and tliat tlie appiipnLS was 1 were a resident of
Date (monfh. day. Yea�
Date (month. day, year)