HomeMy WebLinkAboutMortgage_Meeks.r�'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Year
F, FOR DEDUCTION FROM ASSESSED VALUATION
Stale Farm 43709 (R8 / 2-07)
•��� Presaibed by Depanmenl of Local Govemmenl Finance
INSTRUCTIONS: MAR O V rE1[iOSdric
To be filed in person or by mail wdh the CountyAuditoi ol the county where the property is located. �
Fding Dates: 7) Real PropeAy: Durrng the 12 months before June 11 0l the }rear the deduction is to be eRet6ve. —yy�
2) Mobile Homes assessed under IC 6-1 J-7: Between January 75 and March 2 0/ the year the deductidn"!� ��°' e.
See reverse side la additional insWCtions arrd qualifications. QIBSON COUNTY AUDIipFi
%% � /� n �\ \ /l�% n.
I Applicant (owner nf�eqt r_ see re� ons Side) _ � �
rdlue of 2al prOpaty as of March 1. qment year
exaa
i 3 a� L c,�.i�boo.y�S-vo� - I R�b
Mortgage I iM�ness unpaiA as of March 1, Is ihe appfimnt U
If o.metl with someme dher than spouu, indicate with whom.
❑Yes ❑ No
If name m recwd is d"Aterent ihan Ihat of appicant, irMicate below: Is ihe property in question:
❑ Real Pmperty ❑ Mobile Home pC 61.
Name of mortgagee or cantract seller
Address ot morigagee or mnUact saller (num6et aM stree(. dty. al , aM ZIP code) ;� : 3•G • 0 9
1�Ot'��' ( (� -
Name of assi9nee w oUrer oxner or hddet of morigege �
Addressofasvgnee(num6eraMSVeet city, stafe. a�MZlPaode) T N� 7 D � //�. /
y `
Does applicant own proparty in any other If yes, what caunt�? Whal Ta' /�/� ��'y—� erty
wunry in Inda�a? ' � 1 �'
❑Yes � No �'" Na
COUNTYAUDRG /—��� � ' " — �� _
Deduciion approved in the amount of: �
20 � 20 _ 20 _ 20 ^ Vl U� �W O� _
Counry
I/ We certif� under enally of pe � that Uie above and foregoing intortnaGOn is
Indiana and owner f th aforemen on property on March 1, 20
aawre (owners !WI na
h ,�,�f 7Y/ � s�4sE. co��f2sos
0 rastlent address of applicant (number end streeL ci(y. sfafe. aiM ZIP mde)
Person aulhonzetl by duly ezeculed Power ot Nimnay or by IC G7.1-12-.07
Address of aulhor¢ed parson (number aM streef, aty. stafe. eMZIP code)
scva rl4�s 3- G- ��
(monN. daY• YeeA
Offie (nimN, day, yea�
d ot