HomeMy WebLinkAboutMortgage_Elpers (20)i� �At STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
1\i s FOR DEDUCTION FROM ASSESSED VALUATION
`�. �' Slate Form 43709 (R6 / 5-06) . . . � '
� M Presaibed by Deparimenl of Lool Gwemment Finance
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor o/ the county where the p�operty is located. 2 Z007
Filing Dates: 1) Real Property: During the 12 months belo2 ,lune 11 of fhe yea� lhe deduction is to be elfe��eT 1
2) Mobile Homes assessed unde� IC 6-7.1-7: Between January 15 and March 2 of fhe year the deducGon is� effective.
See reverse srde /or additional instiuctlons and qualifications. �� �
- � GIBSON COUNTY AUDITOR
(owner or contr�eY6�yer - see 2strictions on
Assed'sed value of real property as of
Marrh 1, cunent year
\ I Record
a �-a3-o i-�oo-000.�
,
.' Mortgage / Contrad indebtedness unpaid as of
` March 1, nt year
" �/309OC'� _
If no, wha! is his / her exad share of interest?
� /
l� �9
Is the applipnt the sole legal or
ownef? ❑ Yes ❑ No
If owned wilh someone other than spouse, indicate with whom.
If name on record is d"rfferent Ihan that of applicant, indicate below: Is the pi
❑ Real
,me of mortgagee or contract seller r,/�� /
b n„n�
� (/ U�J/ . .
Address of mortgagee or conVact seller (number and street, city, state, ZIP
asiignee or other owner or holder of mortgage
of assignee (number and street, city, sfate, ZIP code)
Does apppcaM own property in any other If ve�-�•�-• -- "" Distrid?
county in Indiana? ,
Dra���er \O.�pQ7:•��97
DeduGion approved in the amount c� ara ��� r.� / �v' a o
..T.�/4vn �
20 U b' I 20
Signature
20 __ I 20 I 20
County Auditor
❑ Mobite Home pC 61.
Has this dedudion been requested on
property for cunent yeaR � Yes ❑ No
20
Date
3�]
certify under the penalry of perjury that the aaove and toregoing information is irue and corred and that ihe applicants was / were
fenl of Indiana and owner of the aforementioned properfy on March 1, 20
Person authorized b�
or by IC 6-1.1-12-.07
>itlent atltlress of apolicant �A� �s T•RUTi� IAddress of authorized person
O�y. C SR,�B �i7G 24 I