HomeMy WebLinkAboutMortgage_Naas (2)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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Presaibed by Department of Loral Govemment Finance
� (� �.� v� NTERED tpR TqXATfON
INSTRUCTIONS: 0 Subjecf to finaf acEd�f�!1.a�ic(or trans(er
To 6e filed in person or by mail with the County Auditor o/ the county where the propeRy is locate�_ day o(
Filing Dates: 1J Real Property: Dunng the 12 montbs belore May 11 0l the year the deduction is to , e eBective �� —
2) Mo6ile Homes assessed under IC 6-1.1-7: Between�January 15 and March 2 of t year t�e deduction is to be effective.
Auditor
See reverse side for additional instructions and qualifications. �-� Gibson County
Parcel u
Applicanl (o ner or contrac buyer - see
Taxing Dislri� � � �
_ V r �/^�
Assessed value of r property as of
March 1, wrrent year
If no, what is his / her exact share of interest7
reverse
number / legal
Record number,l �
aC
Page number
vo - oo� ,3- S77
MoRgage / Contract indebtedness unpaid as of Is the applicant the sole legal or
March 1, current year ownef? gJ(es ❑ No
If name on record is different lhan ihat of applicant, indicate below:
�me of mortgagee or contrad seller G/
�.J --�
If owned with someone other than spouse, indicate with whom.
Address of mortgagee or contract seller (number and st2et, dty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what county?
county in Indiana?
2�
Signature
approved in the amount of:
��71� � . ,
P I �
COUNTY
� �Y
County Auditor
What
Is the
❑ Mobile Hwne (IC 61.1
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We certify under lhe penalty of perjury that the above and foregoing information is lrue and corred
(°sident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized b�
or by IC 6-1.1-12-.07
Full resident address of appGcant Address of authorized person
�0Rli/Boxf�o8 Conf'�%ana,2N�i7G/a
of
/ were