HomeMy WebLinkAboutMortgage_Trayler��'A� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�i: � FOR DEDUCTION FROM ASSESSED VALUATION .
�+ _ «. / Slate Form 43709 (R6 / 5-06) -
Prescnbed by Departmenl ot Laal Gwemment Finaxe
INSTRUCTIONS:
Count Township Year
_ � .
JU File Mark
To be frled in person or by mail with the County Auditor of the county whe2 fhe property is located. N j 1 Z���
Filing Dates: 1) Real Property: Dunng the 12 months before June Il of the yea� lhe deduction is to be effective. .
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the yeai�tt� deduch'on is to be effective.
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See reverse side for additional instructions and qualifications. GIBSON C NTY �
, UCITOF
(owner or ¢pntkact buyer -
Taxing Distrid "
��>���-�-Q-�-�
value of real property
March 1, wrrent year
If no, what is his / her exact share of interesf?
If name on record is different than that
mortgagee or contract seller
reverse
Key number / I��al description � Record number
a�-I�-14-1oi
Mortgage / Contrad indebte
March 1, current year
/9/���.age number
�
as or is me appncam me soie iegai or
ownef? ❑ Yes ❑ No
a sc�o I
If owned with someone other lhan spouse, indicate with whom.
below:
Address of mortgagee or contrad seller (number and st2et, city,
Name of assignee or other owner or holder of mortgage
Address
state, Z/P co�
Dces applipr' . What Taxing Distrid?
county in Indi . � ��y�
Dra���cr \TC�(..C/,�-.�'�%3
rd NQO /. ..................... NTY AUDITOR
Deduction ap� ��) G—p��, ��,, 433. 7 Z
� � ��
zo �y_ 2o zo
P
County Auditor
❑ Real Propertv ❑ Mobile Hane pC 6-1.
Has this dedudion been requested on
property for current yeaf? � Yes ❑ No
�
Date
zo
We certify under lhe penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
full
Person authorized by duly executed Power of Atlomey
or by IC 6-1.1-12-.07
resident address of applicant ' ' 'Y �� � o Address of authorized person
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