HomeMy WebLinkAboutMortgage_Gries (2)i:�� � STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
i'�; FOR DEDUCTION FROM ASSESSED VALUATION Count 7ownship Year
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� ��' Stale Form 43709 (R6 / 5-06)
�' Presaibed by �epariment of Loral Gavemment Finance �
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INSTRUCTIONS: ,f Q��� C��OH
To be filed in person or by mail wifh the County Audilor of the county where the propeRy is localed.
Filing Dates: 1) Real Property: Dunng the 12 months before June Il of the year the deduction is to be etlecti✓'��yy� ,(��
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o(the year the ded`uc°�h�i6�8 eBective.
See reverse side fo� additional insfiuctions and qualifications. GIBSON COUNTY AUOITOR
Apptica ownero�contract buyer- see restri ' on reverse side)
Taxing istrid Key number / legal description Record number ^ Q O�
a�-a3 -0 6 -�o.-�a �
Page number � f / p
a59-oo Jo
Assessed value of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curcent year March 1, current year owneR ❑ Yes ❑ No
l�d, �oo
Ii no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different ihan that of appticanf, indicate below: Is the property in question:
O Real Properiy _ O Moh�b F+^^�� "^ 61.1-�
e of mortgagee or contrad seller �/� —� -- ���,,y p/�.Q�
llra�F�cr N0/.� �•••d..�P.
Address of mortgagee or contract seller (number and street, city, state, ZIP -' '"
Cat'(� �0.�..
...i ........00 ..
Name of assignee or other owner or holder of moAgage /�� ��,
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Address of assignee (num6er and sheet, city, state, ZIP code)
Dces applipnt own property in any other If yes, what county? What Taxing Distrid? Has lhis dedudion been requested on
county in Indiana? property for current year? 0 Yes � No
COUNTY AUDITOR
Deduction approved in the amount of:
20 0$ 20 � 20 20 20 20 20
P P
Signalure County Auditor Dale
Ve certify under the penalty of perjury that the above and toregoing information is true and corred and lhal lhe applicants was / were
asident of Indiana and owner of the aforementioned property on March 1, 20
� Signature (owners (ull name) . Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
resident address of applicant Address of authorized person
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