HomeMy WebLinkAboutMortgage_Geuss;ei —�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
=�`i'� = FOR DEDUCTION FROM ASSESSED VALUATION
J S�ale Fortn 43709 (R6/ S-06)
� Presaibed by Oepartment of Loral Gwemment Finance
INSTRUCTIONS:
Count Township Year .
JUN 2 f'`�dd�`
To be /iled in person or by mail with the County Audito� of the county where the prope�ty is locafed.
Filing Dates: 7) Real P�operty: Dunng the 12 months before ,lune 11 0/ the year lhe deduction is to be e e trve. �y�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the yea���arot�(to 6e elfective.
See �everse side for additional instructions and quali(rcations. GIBSON COUNTY UDITOR
Applicant (ownerorcontract buyer- see Mctions on verse side)
TaXing istrid � � Key numbe� / legal description Record number /�
`��� �n'�j OS",30(}-OOD,7`j�A�L� Pagenumber �
3
Assessed value af real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year March 1, current year owneR ❑ Yes ❑ No
9 6,
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
I( name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home QC 61.1-�
me of mortgagee or contrad seller •
Address of mortgagee or contrad seller (number and street, city, state, ZI
Name of assignee or olher owner or holder of mortgage
Address of assignee (number and sfreet, city, sfate, ZIP code)
Does applipnt own property in any other If yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for current yeaR 0 Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 O� 20 � 20 20 20 20 20
Signature County Auditor Date
�� We certify under the penalty of perjury ihat the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
S' nature owners full name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07 �
re i e t add ess of appl' t Address of authorized person
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