HomeMy WebLinkAboutMortgage_Dressler°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (RS / 2-07)
�' u�. � F'resrnbed by Departmenl W Loca� Go�emment Firance
INSTRUC770NS:
To be filed in person or by mad with the CountyAuditor o/ the cnunty where Ure pmperty is locafed. A P R 1 1 Z��B
Fding Dates: 1) Real Propelty: Ounng the 12 months before June 11 d the year the deduction is to be efleclive. .
2) Mobile Homes assessed under IC 6-7.1-7: Behveen January 75 and March 2 of Uie year the deduction is to be elfeclive.
See reverse side for edditional instructions ared qualificafions. �� ��
see resNCnans m
March 1, ttrrenl y�r
than Ihal of applicanL indimie below:
Name af matgagce orcmLaa seller
Address of rtartgagce w mntraa sell
Name of auigrrea or dher own�x or f
AdNess of assigriea (nwnber arrd sM
• ��p� -
actindebtedness
sta(e. and ZIP
dty, sfefe, aM ZIP code)
applicanl own properry In erry o�her
y in Indiara?
❑Yes ❑ No
clion apprwed in the amwnt of:
zo nR zo 0 5
GIBSON
as of March 1, I Is �he appfimnt Iha sde legal w equitade ovmeR
❑Yes ❑No
Ih someone dher Uan spouse. irWicate wiih whom.
w� T�e
/��!�
Dra�ver NO.��.-.....
�
CardNO . .....................
Is ihe property in queslion:
❑ Real Property ❑ Mobile Home (IC 6-1.
dudim been requested on praperty
Y�n
❑ Yes ❑ No
zo
L�Fi�
zo
I I We certify under ihe penalty of perjury that fhe above and foregoing infortnation is true and oorrect and Uiat the applinnts was / vrere a resident of
Indiana and owner of the aforementionec; property on March 1, 20 _ __
�
u ot applicaril (number and streeL cify. state, and LP oode)
G✓ /(lo? S S �f �4+<
by duly erzewled Power of Al�umey d by IC G7.1-12-.07
Adtlress af a Wwi¢ed person (number arrd shee; city. sfafe, aiM LP code)
Date (mnnM, day, yea�
(monN. daY. Y��)