HomeMy WebLinkAboutMortgage_Elpers (7).• °'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi Year
FOR DEDUCTION FROM ASSESSED VALUATION
s�a Fo� aa�os �ae i zo��
•� uu � Resrnbed by DePerlment W Loral Govemmenl Finance
N� �� 2008
INSTRUCTIONS:
To be filed in person or by mad with fhe CounlyAuAitor o/ the courrty where the piope,ty ia located.
Fd'v�g Dates: i) Real Properfy.' During the 12 rtronths be(ore June 77 0/ the year the deduction is to be elfective. �,{�-
2) Mobile Hames assessed'mdei IC 61.1-7: Behveen January 15 and March 2 07 the year the deduction is to be . '�F
See reverse side /w additional insWcGons ard qualifitations. V
GIBSON COUNTY �AUDITOR
Appica er or mntracf Mryer - see re�ms m reverse side)n /
Tadng 'd Key numb� §I a es�/' �(l / �O. /� ^ OQ ^
/ l/ /. J� G � C(
�/' t � / / /
Assessetl rdue of rral poperty as of March 1, acrent ymr Mortgage I ConUacl iMebledness unpaid as o( March 1,
ainent Y� O C�6.LJ
If�Mal is his! har exad share M inlerest? If owrc.M with someane olher �h
if reme m remrd is d'Aleren! ihan thal of applicaM, i�nte below: .
Name of rrortgagee or corNaG seller
:
nm.ess or monyagee « oonvaa srJler (lum, arw sa
Name of assgnee a olher owner or hdtler W mptgaga
Address of assignee (n1miber arM sheet, dty, slate, and
Dces applican� own property in any o�her
cauMy in indiana7
❑Yes ❑ No
DeduUion apprwed in ihe amwnt of:
20 � 20 _
dty. stafa. and LP code)
yes.
�
VJhat Tawig Disirictl
COUNTYAUDROR
20 _ I 20 _
Recoid
sP�se. iMicate wilh whom.
w e�ryrivae oWrre(1
❑Yes ❑No
—__ _'''-Z\
Dra�r�er NO°�.�;',`�-,6oS�
Card NO . ......q...............
/'�j 00 �,w
Hes UV5 tl�
forairtent
20
�,�es1eC on property
❑Yes ❑No
Dale (manlh. OaY. Yea�
�
I I We cerUy under the penally of perjury ihat the above and foregoing infortnation is true and mrtecl and that ihe appGranis was / were a residenl of
Indiana and owner oi the afwementimed property on March 1, 2b
ironii.atnw�nrs B,n rumal Da1e (month. daY• Y��
� of applicanl (num r and sbeel. dty, s fe, arW LP
T � � 4�n /'l� }�IS%
by duly ezeculed Pa.ver of Nlarrey w try IC &1.1-72-
oate
I Address of aulhoraetl person (num6er aM s4eet, aty, state. aM ZIP wde) _' J_ _ _ _ ._ _
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