HomeMy WebLinkAboutMortgage_Gulledge.►°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Towm.
_- FOR DEDUCTION FROM ASSESSED VALUATION�Q
Stale Fortn 43709 (R8 / 2-07) ��
�' � Presmbed by Department ot Local Goremment Finance ^�
,•,• �r � FII a
lNSTRUC770NS:
To be fiied in person or by mad with the CourttyAuditor o7 fhe couMy wheie the pioperfy is iocated�
Fding Dates: 1J Real Property: Dunng the 72 months be(we June 11 o/the year the dedoction is to eRe .
2) Mo6ile Hanes assessed under IC 67.7-7: Behveen January 15 and March 2 of the year the deduction is fo be,aeflective.
See reverse side for additional insWCtions arM quali(cafions. AuG � 1 ZQDa
qppicaN �=ar mn4acf buy�r,- see ie m r�ve�m/1 �_ A ��%J N'""/�
s �� u �.,
Ta�dng Dis�n�t nwn / I al tlesa
• f� �(�I �Dl -
assessed�.�,eor��yasdn+a�a,i,a„anyea� nu
ofinteresl7
that ot appinn4 irWicate 6elow:
Name of naNgagee or contract seller
Address of mortgagee a mnUad seller (numbuaiM sfreef, dty, sl
Name of asv9nee wW�a oaner a hdder of rtwrtgage
Address o( assignee (mirt�ber aiM sLee4 ciN. 5afe, and ZIP mde)
iicanl wm property in any dher If yes,
Indiara?
❑ Yes ❑ No
DeduGion
�
the amount oC
Year
Y 3 � b GIBSON �� �• - - - - �
/ ContraU indeMetl�fess unpaid as of March 1, Is Ihe appGranl sda legal a eq ��ade wmen
�' L � � - ❑Yes ❑No
sorrreone IXher Ihan spouu. indiwte with whom.
Is Ihe praperty in queslion:
0 Real Procertv ❑ Mobile Home OC 6-1.
Wha� Tazing Dis�ncl?
COUNTY AUDfTOR
2p ' 20 _ I 20 I 20
20
requested on properry
❑Yes ❑ No
�
SigriaWre of Counry AuCibr Counry I Dale (monN. OaY. Y��)
I/ We certify under ihe penalty of perjury that fhe above and foregoinq infortnatbn is true and mrrect and that the applicants was 1 were a resident of
Indiana and owner of the aforementioned propeAy on March 1, 20
Sqn�INe (owne/s lyf name) � �% / _ Oafe immth. daY Y��)
aiM ZIP oode)
ezeaAed Power of Allomey or by
AdCress of aulhw¢ed person (numbei aM sfree; aty, sfafe. aM ZIP ootle)
day,yean