HomeMy WebLinkAboutMortgage_Bittner (4).r °� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fartn 43709 (RB / 2-07)
�' � f presrnbed by Depa�iment of Local Govertment Firunce
INSTRUCTIONS:
To be fiied in person or by mad with the CountyAuditor ol the county where the property is located.
Fding Dates: 1) Real Property: Dunng the 72 months befwe June 11 0/ the year the deduction is to be eflacdve. �,� ^y 0 Q�Q �$
2) Mobrle Homes assessed under IC 67.1-7: Behveen January 15 and March 2 0/ fhe year the deduc�QKit fs to bg e ective.
See reverse side fa additional ins6uc6ons a� qualifcations.
�
Applicain (o m� 6vyer - se�es6n.tiqnj m reverse side)
/.� if �/-Ff—N n A� GIBSON COUNTY AUDITOR
I I�/v- VV �
2yl pq�uty as oF March 1. aurent ypr MoMgage / Contrac
curtent year �
her esaci share of intemsl?
If �me on record is dif(erent �han �ha( oi applirant, indiqle below:
Name of nwri9a9ee or canUad seller �
—y
Address of mortgagee or mniraQ seller (num6er and ffi . dty, stale, and e
Name of aui9nee a dher owrrer or Iw�der of mortga9e
Address ot asv9nee (number arrd st2eG city, state, aM ZIP mtle)
Dces applicant awn property in any olher If yes, whal counry?
county in Indiana?
❑Yes ❑ No
approved in lhe amount of:
� .. � + • �
as oi March i. � �s ihe applicanl lhe sde legal ro
If o.med with someone olher Uan spouse,
COUNTYAUDROR
20 � Za
❑ No
�s � WWeM in 9uestion:
�p Real Property ❑ Mobile Hwne QC G7.
Has �his deduction been
fo� arrent yeaR
rza
uesled on pmperty
❑ Yes ❑ No
�
�uWre of CounryAudMr County Date (monlh, day, yea�
I/ We certify under the penally of perjury that Uie above and foregoing infortnafion is true and correct and that the applicants was I were a resident of
Indiana and owner of ihe aforementioned property on March 1, 20
,........., i....,.,a�.. e.n..�...o� . 0 Date (rtronN, daY. Y�A
\ r{'/ J o i. J
/� ;idenl address of applicaM
P�� aulhorrzed by Auy exean
IAddress of auttroi¢ed perswi (�
�erandstreet.cify,sfafe arMLlf'm
�� �C/� �
Her of At�umey « by IC 67.1-72-.07
arM street cil}; sfate, aM LP code)
�N ��7 �
Date (mmfh, day, yea,