HomeMy WebLinkAboutMortgage_Higgins.+°•��. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
�.. _ � FOR DEDUCTION FROM ASSESSED VALUATION
• S�ate Fartn 43709 (R8l 2-07)
's._ lJ pry�y� y�, pePaNment o( Lacal Govemmenl Firarxe
INSTRUCTIONS:
To be filed in person or by mad with the CountyAuditor ol the county whera the property is located. Q U G 1 p�oo$
Fding Dates: 1 J Real Propelty: During the 72 months be/we June 77 W the yea� the deduction is fo be afieclive. o
2) Mobile Homes assessed unde� IC 6-1.1-7: Behveen January 15 and March 2 0/ fhe year the deduction is to be eflective.
See reve�se side for additbnal instructions and qualifications.
'__ /l.f�_
rral praperty as
/ ha euU share of interesl?
If reme on recmd is ditferent ihan Ihal of applicant,
Name ot mwtgagee or caniract
�vv•t�v�• i ia vaT
Mw(gage / Contracl intleIXedness unpaid as of March 1,
°'rt�'"�� ( ?D OtSD
belav:
Address of mortgagee w mntracl seilet (number arM streef. aty. sWte. ard ZIP ca0e)
awrrer or hdder of moriga9e
azvgnee (rnenbe` aM sheef. dty. stafe. aiM Z/P cotle)
Dces applicant avn property in any oiher
counry in Indaria?
❑ Yes ❑ No
DeducGOn appmved'oi ihe amwnt of:
20 �✓ 20 _
/
Si]iature of Counry Audi�or
I/ We certify under Ihe penal
Indi nd owner of tl�e
S" (�r e/slu/lneme)�
G✓ r
�.,A resident address af applicaM�v (
(`�'O() tAST l�!
Person aulfwi¢ed by duly exeated
ye5, what county7
20
What Ta�cing DisUicl]
COUNTY AUDITOR
20_ � 20_
GIBSON
spouse. �ca1e wiU wham.
AUDITOR
„ ��ae �n
❑ Yes ❑ No
Is ihe property in question:
� Real Prooertv ❑ Mobile Hane (IC E 7.
Has
fw c
uested on WoPeM
❑ Yes ❑ No
20 _ 20
Date (monlh, day, yea�
� � �
of perjury ttiat the above and foregoinq infwrtiation is We and correU and that Ihe applirants was / were a resident of
��nen6on perty on March 7, 20 _
Oate ( N, da yea�
7 o8�ab�2uJ2
vandsGeet.dfy.sfafe.a ZlPmOe)
zov S �,hs�ia�� r /N �f7�e3�i
er of Atinrney a by IC 61.1-12-.07
person (numberaMSfreeLaty.state.a�MZlPcode)
day, year)