HomeMy WebLinkAboutMortgage_Hutchinson� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
S / State Form 63709 (RS / 4�03) � � , �
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P E9d D rt
`� resrn by epa mem o� Local Govemment Finance � �
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,%' wsrRUCnoNS: AUG 1 0 206b�Ma�`
To 6e filed in person or 6y mail wifh the County Auditor ol the county where the property is located.
Filing Dates: 1J Real Property: Dunng the 12 months 6efore May 11 0/ fhe year the deduction is to 6e eflective.
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the�yeac� ,d"educJion is to be eHective.
See reverse side /or additional instructions and uali�cations. �
Q GIBSON COUNTV AUBlibfi
Applicant ier contract buyer- see
Taxin i tri
� (�.,
Assessed value of reat property as of �
March 1, wrrent year
If no, what is his / her exact share
� �
Key numb r/ legal description Record number /
�G - S�a: -acm-o2m.�9a'-c�sG � c,
� � _ � ��. �� Page number � �/�
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MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or
March 1, cunent year owneR � ❑ Yes ❑ No
��Odv
If name on record is different than thaf of applicanl,
mortgagee or contrad seller ��
below:
If owned with someone other than spouse, indicate with whom.
Address of mortgagee or contrad selier (nilmber and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Does a�
munty i
oee�...,._.._—�— �
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Dra��'er NO..pC�4Y•••..,,. de)
ty?
What Taxing Distrid?
Card NO. .. y�,�J�0 �5 .....
..�RCOS,oc.Y�. o° .
�0������Co. ;OUNTYAUDITOR
�dr.,
Deductiu�� approved in the amount of:
20 �_ 20�_ 20 �
\ � �
Signature
�
County Auditor
20
Is the property in question:
❑ Real Property ❑ Mobile Home OC 6�1.
Has this deduction been requested on
property for wrrenl year?� Yes❑ No
20
20
We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
�esident of Indiana and owner of the aforementioned property on March 1, 20
II resid�nt address of applicant
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Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person