HomeMy WebLinkAboutMortgage_Nixon (2);aF rt°�° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
��s`�� FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
J = S�ate Form 43709 (R6 / 5-06) • . � - . '
� Presaibed 5y Depariment af Lonl Gwemrtrent Finance
To beR eC�TION Sson orby mail with the CountyAuditor of the county where the p�opedy is I ated� � 3LJ�il M
Filing Dates: 1) Real Property: Dunng the 72 months befoie June 1 i of the yea� the deduction is to be ellective.
2). Mobile Homes assessed under IC 6-1.1 J: Between January 15 and March 2 of the�� the �'eQ(�n is to be effective.
See reverse side for additional instnictlons and quali�cations.
Applicant (owneror�
Taxing Dis d
� �. .
Assessed�falue of real property as of
March 1, current year �
It no, whal is his / her exact share of interest?
�
�GIBSON C
Q����
/legal
a�1�-3�- �vv-vaa.�� � bE
Mortgage / Contract indebtedness unpaid as of Is the a�
March 1, current year owneR
aao.oac�
If name on record is different lhan that of applicant, indicate
�me of mortgagee or contrad seller � , i
Address of moAgagee or conlract seller (number and sGeet,
Name of assignee or other ''-'�ier� ortgage
below:
state, ZIP '
��
c me soie iegai or
❑ Yes ❑ No
with someone other lhan spouse, indicate with whom.
Is the property in queslion:
❑ Real Property ❑ Mobile Hane OC 61.
� �� ���
Address of assignee (nun Dra�ti�er �� l —_ _ I yn,�� yn Q )
�..�t% �I ,�20,4J14/7C.it...p•�i
•7.;�'���f ��
Does applipnt own prop Card l�*Q t Taxin � b- 30- aoo 7
county in Indiana? . „ . I
c�� � .. . . .. , �I aao,�ao.°%
/ /,OG'p IDITORI �^ �° �j
Deduction approved in the �mount of: I ��.1�� —�"`v I
�-C
��):��I�'�FZ�]
P ( n
Signature
County Auditor
\ � i�
�. � •
Date
We certify under the penalty of perjury that the above and foregoing information is true and corred and thal ihe applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
ire (owners full name)
r ��
//
;ident address of applicant
�93 bJ l000 S �
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person