HomeMy WebLinkAboutMortgage_Kissel (3).• °'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
� FOR DEDUCTION FROM ASSESSED VALUATION � g'� '
SlateFartn437W(R8I2O7) � ���
•' .., 1 Presaibed by Department of local Goremment Finance ��
wsrnucnoNS .1� �a'�` 2008
To be filed in person or by mad wifh the CountyAuditor of fhe county where the pivpeAy is located.
Fding Dates: 1J Real PropeAy Dunng the 72 months belore June 17 o/the year the deducGOn is to be eAeclive. `yy��� �
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and MaicA 2 0/ the year the deducfion is fo bel�IfE�6�. �
See reverse side lor additional instrvc6ons arrd qualifications. ��
GIBSON COUNTY AUDITOR
P,pdican ( erormnkaQbuyer-seergshicUonsaypveneside) � , � �
�
mimber/
.�� i or [� -i � -
of real popaty as of MaN� 1. ctrrent year
I'�+hat is his I her exaU share
If �me on record is d'rfterent �han Ihal of applitant, indinte below:
Name ot rtar�gagee or caitract seller /� I �
/b"
Address of mo�9agee a cmtratl seller (number arM ef, tity, sfafe,
Name af assigriee w ofha owne� w holtlE
r ee
Address of assig�ue (numbei aM sVeet,
Dces applicanl own property in arry dher
caunry in India�?
❑ Yes ❑ No
Deduction apP�� � �e amount of:
mongage
dty, sta(e. and LP mde)
If yes,
-vo�. v�3-oa�
�ct iMebtednass wipaid as of March 1.
p flq_ I 20 _ I 20 I 20
Texing Disincl?
Remrd
IsNe
spouse,
❑Yes ❑No
IS I�IC pf0p2llY N Qt185b0l1: -�
❑R��� �•• �
� :E��o..Ug'��,°N
- v��\\
— Car� \0• "' �
�wrt
20 I 20
_..� requested on property
❑ Yes ❑ No
20
Sigrewre oi Camry Audnor Counry Oafe (irwnlh, day, yea�
I/ We certify under the penaity of perjury that the above and foregoing infortnation is true and mrrect and that the applicants was I were a resident of
Indiana and owner of ihe atwemen6oned property on March 1, 20
!.1 ' ' e (mvne(s hdl �) �� Date (mmN, daY. Y��
\��
n o-nnt.a
asident address af appliranl (num6er and slieet. city. state, and ZIP mde)
o a b w i 0.,.bg�t�(� �1/ u 639
Permn aulhor¢ed bY �+N e:ecvled Power of Attwney w by IC 61.1-12-.07 Oate (manth, daY. Y�A
of auUqr¢ed person (n�mber aM sheeG