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.r.°•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
,,�,..... ; FOR DEDUCTION FROM ASSESSED VALUATION
' State Form 43709 (R8/ 2-07)
'� .- ' Presvibed by Depanment of Local Govemmenl Finance
ile
INSTRUCTIONS: I
To be filed in person or by mad wdh the CountyAuditor o7 the county where the property is brated.
Fding Dates: 7) Real Property: Dunng the 7 2 months be(ore June 77 0/ the year fhe deduc6on is to be el/ec6ve. e G p q, 20 0$
2) Mobile Homes assessed under IC 64. b7: Be7ween January 15 and Ma2h 2 of the yea� the deduction is tdbe'eHE�Gve.
See reverse side la addifional insWCtions and qualifications.
IisUiGp Key
d ralue o as of March
at is his / Icer e�U stare of in�ere
m recortl is dA(erenl ihan Uiat W a
on reverse sde)
1. qrrent year I Mortgage / ConUact iMebtedness
wrrenl year � w e
. _
rtqrtgagee a tonVact seiler (num6er arM sheef.
Name of assgnee or other owner a hdder of martgage
Address of ass9nae (number and sVee1.
and
Daes applkaM own praparty in arry dher _ I If ves. wnn� county!
�,.,,s.�,_.:---° TCkOM/l1'S
— � � ��N I�..E� —
Da
D� —d9iy
�� �
d as of March 1.
GIBSON COUNTY AUDITOR
Remrd number Pape nurtiber
If owned riih someone other than spouse, iMfcate
VJhat7axing Distnc
COUNTY AUDITOR
20 20
Counry
5e property in
Real PiopeA
sde legal n equilade owner
❑Yes ❑ No
❑ Mobile Hrnr�e QC 6-1
s Uis deducliai �een requested on property
artenl yea/t
❑Yes ❑ No
20
zo_
1 I We certify under the penalry o! perjury tliat Uie above and foregoing infortnation is true and mrred and that tlie applicants was I were a residenl of
Indiana and owner of the atorementioned property on March 1, 20 �
address
Person authoraed by tlury
(number and slieel. cdy. s(ate. aM
ar by
persp� (numberaM sVeet. ci(Y. slale.
Date (monfh. day, yea�
(monfh. day. Year)