HomeMy WebLinkAboutMortgage_HeckelSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S w - state Form aa7o5 (R5 � a-03) -
� PresaiEed by Departrr.eit of ! ocat Govemment Finance
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INSTRUCTIONS: File Mark
To 6e filed in person or by mail wdh the County Auditor of the county where the property is located �� c� �
Filing Dates: 1) Real Property: Dunng the 12 montbs before May 11 of the year the deduction is toibe eRect�ey� �
2) Mobile Homes assessed under IC 6-1J-7: Between January 15 and March 2 0/ the year fhe dedu�io�sto-be effective.
See reverse side lor additional instn�ctions and quali�cations. N� � 2 S 2��5
(owner
Distrid
Asses�d value of real property a5 of
March 1, current year
on
GIBSON COUNTY
Key number / legal description Record number �
b D �/-f7�Y3 � -o age number � ��
MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, currenl year ownef? ❑ Yes ❑ No
�{ 5O O
If no, what is his / her exad share of interest? Ii owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
mortgagee or contrad seller
Address of mortgagee or cont�act seller (number and sf2et, aty, state, ZIP
Name of assignee or olher owner or holder of mortgage
Address of
st2et, city, state, ZIP code)
❑ Real Property ❑ Mobile Hmie
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for current yea(? � YesO No
Deduction approved in;
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Signature
COUNTY AUDITOR
Dra �ve� —
�'�. QS
C�rd �'O, �S ��:
20
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Date
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ceAify under the penalty of perjury thal lhe .._ �oing infortnation is true and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned prur_ �n March 1, 20
e (�name)
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�ent,ad�� s o�ppli� qov S
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Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ofauthorized person