HomeMy WebLinkAboutMortgage_Saulmon.ti,.
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
� ��� ! Stata Fortn 43709 (RS / d-03) � �{�''Y `��1j��
� PresrribeC.by Department of local Govemment Financa ��_� (� . 5 p)
� A-% ��..%
INSTRUCTIONS: _ . �CT 2� 2��5 File Maric
To be filed in. person or by mail witb the County Audifor of the county where the property is located.
Frling Dates: 1) Resl Property: Dunng the 12 months belore May 11 0/ the year the deduction is-to�be effective.,
r�u«, ._..-„
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the deduction is to be effective.
See reverse side (or additional instnictions and qualifications. GIBSON COUNTY AUDITOR
Taxing Distrid '
� \J•�
Assessed value otrea
March 1, wrrent year
6uyer-see
as of
no, what is his / her exact share
If name on record is different than that of
mortgagee or contraIX seller
on re�rse side)
Key number / legal description Record number O S
l � DCI' ►^j',n Pagenumber ��0�
1 J l ' [�"
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year owne(? ❑ Yes ❑ No
h
If owned with someone other than spouse, indicate with whom.
indicate below:
Address ot mortgagee or contraIX seller (number a street, city,
Name of assignee or other owner or holder of mo gag �r v
Address of assignee (number and stieet, city, state, ZIP code)
Does appiicant own property in any other If yes, what county?
county in Indiana?
Deduction approved in the amounl of:
20 �
SignaWre
ZIP
Taxing Distrid?
COUNTY AUDITOR
2� �. I 2� � I 2� ( 20
County Auditor
s the property in question:
❑ Real Property ❑ Mobile Horne pC 61.1-�
Has this deduction been requested on
property for current year? � Yes� No
20
Date
�
We certify under the penalry of perjury that the above and foregoing information is true and correct and lhal ihe applicants was / were
�esident of I' and �owner of the aforementioned property on March 1, 20
's full
� ��
Person authorized by duly execuled Power of Attomey
or by IC 6-1.1-12-.07
of authorized person