HomeMy WebLinkAboutMortgage_Fetcher� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�. ♦ State Fwm 437W (RS / 4-03) �
�«• -
� Prescribed by DepartmeM o1 Loral Govemment finance
\
wsrRUCrioNS: DEC 2 6'��b�
To be filed in person or by mail with the CountyAuditor o/the county wheie the property is located.
Filing Dates: 1) Real Property: During the 12 months be%re May 11 0/ the year the deduciion is to be eftective. �'"
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year��ej ��c�rryy,to 6e eflective.
See reverse side for additional instructions and qualiTcations. QIBSON COUNTY AUDITOF
Applicant (o�yner or contract buyer- see 2strictions on re rse side) -
`7 1 I
Taxing Districl Key number / legal description
�'�/%Lna-P� �j c f-cr� � 9 9 - �
Assessed J51ue of real property as of
March 1, wrrent year
If oo, what is his / her exad share
MoAgage / Contrac[ ir
March 1, current year
If name on record is different than that of applicant, indicate
of moAgagee or conhact seller � S.T
Record number
D 5-577
Page number
unpaid as of Is the applicant the sole legal or equitable
owneR �es ❑ No
If owned with someone other than spouse, indicate with whom.
of mortgagee or contract selier (number and street, city, state, ZIP
Name of assignee or other owner nr holder of mortqage
assignee (numberand st2et. citv, s�ate. ZfP code)
lhe property in
Does applicanf own nroperty in any olh�r I If,����. 4••hat counry? bVhat Taxing C
county ir Indiana? �
COUNTY AUDITOR
Deduction appro��ed in the amount nl:
zo�
Signature
2n_ D�_ �0 0� zo 20
— �----�-P--�--------�—
__ __.__ _ County Auditor
vdc r��iFj under !nP p,�;�alty of per;ur� +h:,� tne
lesirient of India�fnremen�
❑ Mobile Home (IC 61.
M�111�E1�7_f� IC►�C+f%..
r
���52�g
zo
Date
zo
i on
� Na
3aoino infoTnaGOn is true and corred and that ihe applicants was / were
on March 1. 20
Person a��thorized by duty execuled Power of Htromey
or by IG 6-1J-12-.Oi
rull res�nl ad�ress o( aoblicant � -�� �Address of authorized person