HomeMy WebLinkAboutMortgage_Kamman`° rt�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S- State Form a3709 (R4 / 70-Ot) �j--1
� Prewibe0 Dy Depanment W Local Govemment Finance
INSTRUCTIONS: M%�f�;� �a,�003
To be filed in person or by mail with the County Auditor of the county where fhe property is located.
Filing Dates: 1) Real Property: During the 12 months before May 11 of the year the deduction is to be ective. � `/j/�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 0l the '-the�o!Vr3-to-be�ve.
See reverse side /or additional instructions and quali�cations.
� GIBSON C�OUNTY AUDITOR I
Applicant (owner
see rEstlictions on reverse
Taxing Di 'd //( O� Key number / leg�l a€scription Record number O�
U �O �_ � •��9`�U Page number
„
Asse value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
Mar 1, current year March 1, currer}t-�(ear owne(? ❑ Yes ❑ No
If no, what is his / her exact share of
If name on record is different than ihat of applicant, indicate below:
�me of mortgagee or contracl seller a
Address of mortgagee or contract selier (number and street, c`rty, state, ZIP
Name of assignee or olher owner or holder of mortgage
(num6er and street, city, state, ZIP code)
Does applicant own propeRy in any other I If yes, what wunty?
county in Indiana?
Deduction
20
Signature
someone other than spouse, indicate with whom.
Is lhe property in question:
❑ Real Property ❑ Mobile Home pC fr7.1
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Drawer NO.�-�: ��''9 C�
Ca rd -Np: . . . .'. . . . : . .
WhatTaxi.., .�� �����
COUNTY AUDITOR
in the amount of:
20 20 20 D� 20
County Auditor
Y'�r-
� .r' � �.
on
� No
/ We certify under lhe penalty of peryury thai the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Signalure (owners (u ame) Person authorized by duly ezecuted Power of Attomey
\��..� (� � � or by IC 6-1.1-12-.07
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person