HomeMy WebLinkAboutMortgage_Denton.s°�* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
s�a F«,� a3�os �Ra i z-0»
�9 � Presmbed by DepaNnent ot Local Gavemmenl Firance
4N
INSTRUCT70NS:
To be filed in person or by mad with the CourrtyAuditor o/ fhe courtty wheie the property is bcafed.
Fd'a�g Dates: 1J Real Properfy: During the 12 months be%re June 11 of the year the deduction is to be efleG
2) Mobiie Homes assessed urMer JC 67.1-7: Behveen January 15 end Maich 2 0/ fhe year the
See reverse side for additional insWCtions and q�aGficafions.
Appicara (owner q wnhld �1P! iSee remicBaw m ") �•
�I�i`�I 7S �
ro, whal is his / her ezaG share W it�eresl?
I If �n rernrd is diRereia
Nartre of nahgagee ar wnL-acl seller `
Address of mor�ga9ee a mnlrad seller (number arW .9ree(, dly, sta(e. i
Nartre of assg�e a dher o.rnar a hdder d martgage
Address of assigrree (nmiber aM slreaC city. Aafe. aM ZIP mde)
Dces applicaM own MWerty in arry other It yes. what caunN?
couNy in indiana?
❑Yes ❑ No
� Deduction apprwed in
COUNTY
:wn Township Year
DULY EN' ERED fOR TAX ION<
a� of File a
�
.4uditor
�0 � , gGibson County
id as of March 1. Is U�e app5mnt Iha sde legal a eq�rilahie owne(1
❑Yes ❑No
with sortieone olher than spouse, indicale with whom.
Is Ihe propeM in quesfim:
❑ Real Pfoperty ❑ Mobile Home pC G1.
�p � I p_ I 2(1 I 20 I 20
Has ihis dedudion been requesled an pmpnry
fw artenl yeaR
❑Yes ❑No
20 _ � 20 _
Signature of CountyAUdilor Cwrily Dale (�mnlh. daY. Y��)
I/ We certify under the penally of perjury that fhe above and foregoing infwrnafion is We and correct and tliat the applicants was! were a residenl of
Indiana and owner of ihe aforementioned property on March 1, 20
relwe(owne�s name) Da�elmantli.daY.Y��)
�. / ,� ��' �l �fl �.
t address af appliG�ard (nH(rt6er an0 sGaet dty, state. ard ZIP wde)
�2�1 OG. z� /00 S
,orized by euy e.ea,tea aower m u�w,rer ar by �c c-1.1-iz-.o7
au�tnr¢edpGSOn (nwn6eraMs7ee4�Y.state.andLPmde)
Dale (monUr, day yea�
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