HomeMy WebLinkAboutMortgage_PirkleS" rt�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
e"° ° FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S � � J State Form 43709 (R4 / 70.01) . � -- �� — �,
� PrescfibeC by DeOartment of Local Govemmenl Finance ��
INSTRUCTIONS: F E B �Fpe ��
To be filed in person or 6y mail with the County Auditor o/ the county where the property is IowfE - �
Filing Dates: 1) Real Property: During the 12 months be%re May 11 01 the year the deduction is
2J Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 of
See reverse side for additional instructions,qnd qualifications. �
or contract
on reverse side)
Taxing District Key number / legal descriplion
C�a,��,� �l� - Gb���-�
Assessed value of real property s of MoAgage / Contrad indebtednessyt
March 1, current year March 1, wrrent year �,�
If no, what is his / her exact share of interesl?
If name on record is different ihan that of applicant, indicate below:
�ame of moAgagee or conVact seller ��� ( /
Address of mortgagee or contrad seller (number and st2et,�
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county?
county in Indiana?
Deduction approved in the amount of:
20
r� i � �
,. .c,� i
If
/��
0
What Taxing Distrid?
COUNTY AUDITOR
�
County Auditor
20�Z
e eflecfive.
�ar,tbe,_`d�d�n i.
GIBSON CJOUhiv q<
/ O�_
- 7-�
3g` n\ ber � �`
I
Is lhe applicant the sole legalp e uitable
o ❑ Yes o
er-than sp use, ' icate with whom.
a-��o6
Is the property in question:
❑ Real Propaty ❑ Mobile Hort�e pC 61.1-�
O,� -/��/8'
� /��-.� �DS �,���
. (� . OL - ���/
t
Has this dedudion been requested on
property for current yeaf? � Yes ❑ No
20 �_ 20 ��
P P
Date
/ We certify under the penalty of perjury that the above and foregoing infortnalion is true and corred and that lhe applicanls was / were
�resident of Indiana and owner of the aforemenlioned property on March 1, 20
gnat (owners full na Person authorized by duly execuled Power of Attomey
' or by IC 6-1.1-12-.07
�II resident add�ss of applicant ,, y�/o(o Address of authorized person