HomeMy WebLinkAboutMortgage_Dewig (5).f ""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
� FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fartn 43709 (RS I 2-07)
.S :. � Presmbed by Department of Local Govemment Finance '
�NSrnucnoNS: �
To 6e filed in person or by mad wifh the CountyAuditor o/ the county where fhe pmperty is locafed.
Fdv�g Dafes: f j Real Property: Dunng the 12 months be/ore June 77 0/ the year the deduction is to be eflec6ve. ���Q 'QQ 8
2) Mo6ile Homes assessed under IC 6-1.7-7: Behveen January 15 and Maich 2 o/the year the deduction s o `�9ecLve.
See reverse side for addifional instructions and quali�tafions. ,� �,�
c,ppticam
on reverse side)
t.� �� a
GIBSON
Ta�drg �isUict Key ium6e, / legal�e�iption Rem`d number Page rwmber
� �G•-/�i-3/-3E�v-�GO.o�o -onr/ ��od' .�357
nssessed � m� popeny as or n�m, �. aRe�i r�• MonBaye � co�aa �rwewea�s �nPaid as or n��cr� i, is �ne apae�i u,e sae ie�i a��uae ow.�er:
anrent year
�C, �0�� � ❑Yes ❑No
If+hat is ha / her exacl share aF infe�est? If amed wiU� someone ather than spouse, �cate wi�h wlwm.
If name on ,ecad is difierent Ihan
Name r�gaageeora
��% C �� ' 4
Address of rtqrlgagee u
�(i� �
mber aiM sheef. aty. sfafe. aiM
Nartre af assigriee or Wher owner or hdder of morte�age
Address oFassignee (numbeiaiM sVeel. city. state, aiw
Oces applicant ovm property in arry Wher
caunty u� Indiaria7
❑ Yes ❑ No
DeduGion approved in Ihe amwn� of:
20 2b Q�
Surewreof unlvAU6lor
I/ yes. whal count�? I NTat Taw�g �atric
COUNTY AUDITOR
Zp 20 _ 20
Counry
Pr�rtY
❑ Mobile Home QC 61.
�AJ n y "..
DI':l\�'Cl" �D�Ci.......:..
� •
CaCd NO. ..°Z'�.'�•.........,.
�._.� �. � �
20 _ � 20 _
I/ We certify under the penalty of perjury ttiat the above and foregoing infortnatbn is We and oorred and that the appGCants was / we2 a residenl of
Indiana and ovmer of ihe afwementioned property on March 1, 20 _ �
cny.
�
aWha¢ed by Auty exewted Power of Ntamey or by IC 61.1-12-.07
AEdress of aulMaed persan (number arrd sGee; dty, stafe, arb LP oode)
Date (month, day, yea�
L' �5'Od
Dale (month. daY.Y��