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�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i' = FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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! Sta1e Form 43709 (R6l 5�06)
� Presaibed 6y Dapartment of Local Gwemment Financa
INSTRUCTIONS: MA�,FdB P6adc„07
To be filed in person or by mail with the County Auditor of the county where the propeRy is located. 3 CU
Filing Dates: i) Rea/ Propeity: During the 12 months before June Il of the year the deduction is to be etlective.
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 0l the year the ��n,� � elfective.
See reverse side for additional instructions and qualffications. GIBSON C6UN�Y AUBIfi§p
Applicant
Taxing District
Assessed vatue
March 1, current
buyer
property as of
If no, what is his / her exact share of interest?
on re6erse side)
�f
number / legal description
v �.a
March 1, curtent year
If name on record is different than Ihat of applicant, indicate below:
of mortgagee or contract seller
numbe�
as of Is the applicant the sole legal or
owner? � Yes � No
If owned with someone other than spouse, indicate with whom.
Address of mortgagee or contract seller (number a"nd stieet, city, state, ZIP
Name of assignee or other owner or holder of moRgage ___
Address of assignee (number and street, i q
Does applicant own property in any other . j�j� �_�`�
counry in Indiana? � "' �
�./t�",• �1.�
DeducGon approved in the amount of:
20 O l 20 0 7�
Q P
Signature
COUNTY AUDITOR
20 6�_ 20 20
P
County Auditor
s the property in question:
❑ Real Properry � Mob�le Home (IC fr1.1-7)
- rbs
Has this deduction been requested on
property for curtent year? ❑ Yes❑ No
zo
Date
�
I I We certity under the penalty of perjury that the above and foregoing infortnation is W e and correct and that the applicanks was / were
��ydent of Indiana and owner of the aforementioned property on March 1, 20
or by IC 6-1.1-12-.07
person