HomeMy WebLinkAboutMortgage_Perry (2)i i�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'i' � FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
-J Slate Form 63709 (R6 / 506) . � ..
�N�
� Presaibed by Department of Laal Govemmen� Finance
�NSrRUCnoNS: ��� 1 3 �2�b07a�
To be filed in person or by mail with the County Auditor of the county wherelhe propeRy is located. .
Filing Dates: 1) Rea/ Property: Dunng the 12 months before June 11 of fhe year the deduction is to be ect�ve.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the ye�� is to be eflective.
C
See �everse side /or additional insfnictions and qualifications. GIBSON COUNTY qUDITOR
h
Applicant
Taxing
�
Assessed value of real property
March t, wrrent year
name on
his / her exact share of interest?
than
of mortgagee or conVad
on reverse side)
/ legal desuiption
number
number
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or
March 1, currenl year owner? ❑ Yes ❑ No
indicate below:
Addresa ol moAgagee or. contrad seller (number and streef, city,
Name of assignee or other owner or holder of mortgage
Addresy of assignee (number and st2et, city, sfate, ZIP code)
Does applkant own property in any other If yes, what county?
county in Indiana?
Deduction approved in the amount of:
20�_ 20 20
P P
Signature
If owned with someone other than spouse, indicate with whom.
-- �� o7•5oN/
Is th property in question:
_ _-- .
❑ Rod o-- " ' , .� 1
— �� e��. =s_ �.
� �: f
� ;K : �
��:������-�o.....a9a'] :.. �
C:lyd �O. ...�....
... "rr .
� �at�,�-- .
Taxing Distrid? Has this dedudion been requested on
property for cunent year? Q Yes ❑ No
COUNTY AUDITOR
20
County Auditor
�
20
Date
20
We certify under lhe penalty of perjury that the above and foregoing information is true and corred and thal the applicants was / were
�esident of Indiana and owner of lhe aforementioned property on March 1, 20
Signature (owners full
�.9ti7?
� � JQIe? /vt9�92 0/�ll(9��rN.�:✓
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
authorized person