HomeMy WebLinkAboutMortgage_Meyer (5)� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
z FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
� M� / State Form 63709 (RS / a-03)
PmscribeC by Department ot Local Govemment Finance
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INSTRUCTIONS: a�
To 6e filed in person or by mail with the County Auditor of the county whe2 the property is located. 0 � T �- %����
Filing Dates: iJ Real Property: Dunng the 12 months be%re May 11 of the year the deduction is.to be eBective. ��
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of he year the� d/u1ction is�,!to� bIe/ eRective.
See reverse side for addiGonal instructions and qualificafions. qJ�`�-'-c,�-�—j
GIBSON COUN?t' :UDITOR 1
Applicant (qwr}�r or contrect
�ed value of real property as of
1,cunentyear
If no, what is his / her exact share of
If name on record is diBerent than
of mortgagee or contrect
Address of mortgagee or contract seller
on reverse
/ legal description I Record number
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^„ � M D�� i(71 Page number � p6
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Mortgage / Contract indebtedness unpaid as of Is the applicani the sole legal or equite
March 1, current ear owner? ❑ Yes ❑ No
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If owned with someone other than spouse, indicate with whom.
ant, indicate below: Is the property in question:
� ❑ Real Property ❑ Mobile Hame OC 61.
Name of assignee or other owner or holder of mortgage
cit y,
Address of assignee (number and street, ciry, state. ZIP code)
Does applicant own pmperty in any other If yes, what counry? What Ta-�-- -
countyinlndiana?
COUNTY AUDII
Deduc6on approved in the amount of:
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County Auditor
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Date
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certify under the penalty of perjury that the above and foregoing information is true and correct and that the appiicants was / were
ient ot Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
resident address of applicant`�' � �Address of authorized person --