HomeMy WebLinkAboutMortgage_Barbauldr�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
's•�i; FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
� , State Fwm 43709 (R6 / 5-06) , � � �
���• Presaibed by �epartment of Local Gwemment Finarxe
INSTRUCTIONS: MA�;i� n��008
To be filed in person or by mail with the CountyAuditor of the county where the property is located.
Filing Dates: iJ Real P�operty: During lhe 72 months 6efo2 ,lune �l o/ the year the deduction is to be e/fective�Ija� ,Q
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year fhe deducti6ri is t0 //� ve.
GIBSON COUNTY �ITOFi
See �everse side fo� additiona/ instructions and quali(ications.
Appl' nt (owner o contracf buyer- see restrictions reverse side)
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Taxing istrid Key nu ber / legal description , Record number a D D 7
7d a�-a3-o6-aao- o�•
7��_ O 0 A Page number � q q 6
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Assessed value af reat property as of MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, currenl year March 1, wrrent year owne(? ❑ Yes ❑ No
1 2-a, po�
If no, what is his / her exad share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
�eal Property ❑ Mobile Hmie pC 6-1.1-�
e of mortgagee or contract seller
E �`� a� °�-��°�`� C - u.
Address of mortgagee or contrad seller (number and st2et, city, state, ZIP
Name of assignee or other owner or holder of mortgage
T dl.1/ � ....
Address of assignee (number and street, city, sfate, ZIP code) •••••""'
Dra���er 1� .... .
Does applipnt own property in any other If yes, what counry? Car� � �' "��. �• O••"" �� been requested on
county in Indiana? �`a a^� yea�? � Yes ❑ No
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couNrv _..
Deduction approved in the amount of:
20 �_ 20 �� 20 20 20 20 20
7 �
Signature County Auditor Date
We cert' under lhe ena of perjury that the above and foregoing information is true and correct and that the applicants was / were
esi f 1� ' n ner o e aforementioned property on March 1, 20
X Sig tu (o n ll e) Person authorized by duty execuled Power ot Attomey
or by IC 6-1.1-12-.07
u address of applipnt Address of authorized person
� . Qubst I�1. �16