HomeMy WebLinkAboutMortgage_Georgres°�� STATEMENT OF MORTGAGE OR CONTRACT INDi
g FOR DEDUCTION FROM ASSESSED VALUATION
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�' � Presrnbed by Departmenl of Local Govemmenl Finance
Count Town ' Year
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wsrnucnoNS:
To be filed in person or by mad with the CountyAuditor o/ the courtty whe�e the property is located.
Fding Dates: 1 J Real Property: Dunng the 12 months betore June 17 0/ fhe year the deduction is to be elfecLve. `�97�„��Q�
2) Mobile Hwnes assessed under IC 6-1.1-7: Behveen January 75 and March 2 o/the yeer the deduc6on is to b�e/�
See2versesidefaadditionalinsWc6onsarWqualificafions. GIBSON COUNTY AUDITOR
(o�w�ner�orm`n4�ad' r- - auonreversesd�e) ^
(ilb4/i.P� � �+W
�pd I desrriPtion
���� 6-/3 -3 `i -a�
ralue of real PoP�Y as of Mard� 1, mrent year Morigage �
nurent year
';�vhal is hi5 / her exacl shafe of intetBSt7
�
If name on recwd is drfterent than that of applicanl, in
Name of nwr�qagee or rJler
Address of moN9agee a cmUla seller (number antl
assigriee u dlu� ow�r w
Address o(
Dces applicant ovm praperty in arry dher
counry in Induria?
❑Yes ❑ No
Deduction appmved in �he amoun�
�
SignaWre
�
ma�gage
-�o/. .3 !o -oo `
Conirad inde6tedness unpaid as of March 1,
q� 53�
If owned wi7h someane oll
bNrnr:
d�tyK, u fe. aiM ZIP cn0e)
slafe, antl ZIP mde)
If yes, whal
2p _ I 20
��P7% �
/
sae �ega� «eq�ritaae mmeR
❑Yes � No
Ihan spouu. indcate wilh wMm.
Is U�e property in question:
❑ Real P�tv ❑ Mobile Home (IC 61.
WhalTaxingDi Dl�il�\'Ci l��.r•r^•�: •"-��1�
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counry
Card NO ..,.,,,........ ,.
�P�10 ���`°.a� al�9o, 538 0�
20 20 20
Dale (monlh. daY. Y��
1/ We certify under ihe penalty of perjury that Ihe above and foregoing infortnation is we and cortecl and that the appfirants was / were a resident of
Indiana and owner of the aforementioned property on March 1, 20 _
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1 sdenl address of applicaM (numbcr and shee4 �y. slate. and LP oo0e)
� I`d�6 �- 400S. pQlc�a�� � ,=N 411�40
Pason au�horaed by duy executed Power oflLLlomey or by IC 61.1-72-.07
prlsan (n�mbeiarMStreeGcGy.state.
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