HomeMy WebLinkAboutMortgage_Isaacsii '�� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
�' �• FOR DEDUCTION FROM ASSESSED VALUATION
J • State Fortn 43709 (R6 / 5-06)
Presaibed by Departmem of Local Govemment Finance
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INSTRUCTIONS:
JUN 1.r�,�7QA�
To be filed in person or by mail with the County Auditor o!!he county whe�e the property is located.
Filing Dates: i) Rea/ Property: Dunng the 12 months 6e(ore June 11 of the yea� the deduction is to be e•,}•���,.�,
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year �he d�c��o 6e eBective.
See reverse srde foi additional instiuctions and quali(ications. GIBSON COUNTY AUDITOR
Appticant (own or ntract 6uyer - s strictions on reverse side)
Taxing istrid Key number / legal description Record number O�
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Ass ssed value of real property as of Mortgage / Conlrad indebtedness unpaid as of Is the applicant ihe sole legal or equilable
March 1, current year March 1, wrrent year owner? ❑ Yes ❑ No
If no, what is his / her exact share of interesl? If owned with someone other ihan spouse, indicate with whom.
If name on record is dif(erent than that of applicant, indicate below: Is the property in question:
O Reai PropeAy ❑ Mobile Home (IC 61.1-�
me of mortgagee or contrad seller , �
Address of mortgagee or contrad seller (number and street, city, state, ZIP"
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Name oi assignee or other owner or holder of mortgage
Address of assignee (num6erand s6eet, ciry, state, ZIP code)
Dces applicant own property in any other If yes, what county? VJhat Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for wnent year? � Yes � No
COUNTY AUDITOR
Deduc6on approved in the amount of:
20� 20�� 20�_ 20 20 20 20
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Signature County Auditor Date
� We certify under the penaity of perjury thal the above and foregoing information is true and correct and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 7, 20
Si na e(owners e) Person authorized by duly executed Power of Attomey
X �� or by IC 6-1.1-12-.07
Full resident ad r of applicant Ad ress of aulhorized person
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