HomeMy WebLinkAboutMortgage_Eaton, �i'��' � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�i •�; FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
� w� J Slate Form 43709 (R6 / 5-06)
Presaibed by Departmem of L«al Govemment Finance
INSTRUCTIONS: �1 Fi ric
To be filed in person o� 6y mail with the CountyAuditor o/ the county where the p�operty is IQfia�d� ���
Filing Dates: 1J Real Property: Dunng the 12 monihs 6e%re June 17 of the yea� the deductiog�s to e rva. J
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 o(the year the deduction is to be elfeclive.
See reverse side /or additional instnictions and qualifications. � � N �$ ZO��
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Applicanl (o orconhact buyer- see strictions on reverse side) v a�'�"
GIBSON COUNTY AUDITOR
Taxing Distrid Key number / legal description Record number
a �-a 3 -o� -a� — 7
Page number
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Assessed value of real property as of MoRgage ! Contred indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year March 1, current year ownef? ❑ Yes ❑ No
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I( no, what is his / her exact 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:
❑ Real Property ❑ Mobile Home QC G1.1-�
me of mortgagee or contract seiler N
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Address of mortgagee or contract seller (number and st2et, city, state, ZIP
Name of assignee or other owner ar holder of mortgage
Address of assignee (num6er and st�eet, ciry, state, ZIP code)
Dces applipnt own property in any other If yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for curcent yeaR � Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 �&_ 20 � 20 20 20 20
P P �
Signature County Auditor Date
/ We certity under lhe penalty of peryury that the above and foregoing information is true and correc[ and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property on MarcFi 7, 20
ign�ture (owners (ull name) Person authorized by duly executed Power of Attomey
�� �nl� . � or by IC 6-1.1-12-.07
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Full resi nt address of applicant Address of authorized person
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