HomeMy WebLinkAboutMortgage_Orr�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
-° : FOR DEDUCTION FROM ASSESSED VALUATION
S � State Form 43709 (Ra / 10-01)
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Presaibetl Dy Department N Local Govemment Finance
INSTRUCTIONS:
Coun Township Year
File Mark
To be filed in person or by mail with the County Auditor o! the county whe2 the propeRy is located. APR 2 6 2QQ2
Filing Dates: 1) Real Property: During the 12 months be%re May 11 0l the year the deduction is t eflective.
2) Mobile Homes assessed under IC 6-1.1-7: 8ehveen January 15 and March 31 of year the du t�7(n is iq/.pe �tiective.
See IPVP.f.SP. Ride /nra/Idifinnal insin�ciinnc anil nunlifirn�innc . l^i�'`�l�t�.�12 ��
- - - �- ' '- GIBSON COUh�-v qI�DITOR I
W ron �
Applicant (owner or contract buyer - see restrictions on reverse side)
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Tauing Distrid Key number / legal description - Record number
✓ Page number �
Oo - l� 3
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year ownef? �fes ❑ No
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If no, what is his / her exact share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
eal Property ❑ Mobile Home QC 61.1-�
e of mortgagee or contrad seller
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Address of mortgagee or wntrect seller (number and st2et, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP code)
Does applipnt own property in any other If yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for current yea�?O Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
l
zoe,2—' 2o O 3 2o O zo 20 �_ 20 � zo ��
5 (n.lo gp
P�'�9BoA � �,, P P
Sign ture County Auditor Date
'� We certify under the penalty of perjury that the above and foregoing infortnation is true and correct and that the applicants was / were
esident of Indiana and owner of the aforementio�ed property on Marrh 7, 20
Signature (owners (ull name) Person authorized by duly executed Power of Attomey
� or by IC 6-1.1-12-.07
Fu I resident address ot applicant Address of authorized person
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