HomeMy WebLinkAboutMortgage_Tenbarge (4)�� :STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
�' - w� l SI3�e Fortn 437p9 (RS / 4-03�
� � . � Pres�iibe0 by Departmeni ol Local Govemment Finance
Coun Township Year
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INSTRUCTIONS: File Ma
To be filed in�person or�by mail with the CountyAuditor of the county where the properiy is located ��j 2 4 2���
Filing Dates: 1) Real Property: During fhe 12 months 6efore May 11 0/ the year the deduction is [o be el%ctive.
2J Mobile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 0/ the year th� duction is to be eRective.
See reverse side for additional instructions and qualifrcations. 0"' �� J�
. .� GIBSON COUNTY AUDITOR
Applicant (owner o� confract 6uye� - see restrictions on reverse side)
Taicing
Assessed value of real property as of
March 1, current year �
If no, what is his / her exact share of interest?
number / legal description
�
March 1, current year
If name on record is different lhan that of applicanl, indicate below:
_ �a Pa9e �
unpaid as of Is the a
owneR
iega� or
❑ No
owned with someone other than spouse, indicate with whom.
the
- - � � �llReal Property ❑ Mobile Hor
of mortgagee or contrad seller
3- a�- � �-3�- �/0�-600 .� 33�09
>s of mortgagee or contracl seller (number and street, city, sfate, ZIP �
Name of assignee or other owner or holder of mortgage
:.ddress of assignee (number and street, city, state, ZIP code)
Does appiicant ow
wuny in Indiana?
Deduction
Zo �
�
Signature
any other I If yes, what county? � What Taxing District?
COUNTY AUDITOR
in the amounl of:
20 [� 8 20 0� 20 20
P P ��
County Auditor
Has this deduction been r
property for current year?
zo
�
61.
iestetl on
Yes � No
certi(y under�the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
name)
applicanl
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
person