HomeMy WebLinkAboutMortgage_Pinkston.+"^* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
��:._. _ FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fortn 43709 (RB / 2-07)
�' � Presmbed by Deparlment of Local Govemmenl Firence
INSTRUCTIONS: �
To be filed in person or by mad with the CountyAuditor olthe county whaie the pioperty is located. 200�
Fding Dates: i) Real PropeAy: Dunng the 12 months be)ore June 11 d the year the deduction is to be efiec6ve. ef� � 9
2) Mobile Homes assessed under IC 64.7-7: Between January 15 and March 2 of the year the deduc`D� s to be effec6ve.
Sae reverse side (or addifional insWcfions arrd qualificafions. �,�
Dislnct
num6er /
reverse sde)
GIBSON COUNTY AUDITOR
� - a`3-�7- �aJ -c�� �3 -a a G
pss¢ssed rah�e of real popaty as d Mart�h 1, arteril y�r Mwlgage / Contrad irWebtedness unpaid as of March 1, Is Ne appGcanl e legal or equi�aMa
wR ❑Yes ❑No
o .
If�hy( is his / her exacl share af iriteiesl? If mmed wi�h someone olher Uan spouse, udicate with wlwm.
If reme m remrd is drfterent Ihan Ihat of applicanf, indimle belar. Is ihe property in quesGm: .
eal Properry ❑ Mobile Home QC 61.1
Nameofnar�ga9eaorcan seller <�T� / 'y. �/ n �
t/
AOCress of mortgagee a mnlra I n ber aM sheeG diy. stafe. aM LP�c e� ���.`X—
Name of assignea a alher oxw w hdder of mor�gage
(number arid sbaef, dty, sfafe, antl
Does applicant own property in arry olher
county in Indiana?
❑Yes ❑ No
appmved in ihe amount of:
� • i�
AudMr
If yes, what counly? What Ta�dng Dislnc
COUNTYAUDROR
20 20 20
Counry
Has Utis dedudion been requesled on property
rrn a,nent yean
❑Yes ❑No
20
yea�
20
I I We certify under the penalty of perjury that the above and fwegoing infortnation is We and mrrecl and Uiat fhe appGcants was / were a resident of
Indiana and owner of� aforementioned property on March 1, 20
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+ydentaddressoiapplicanl(numberands6ee7.dty.sfate.ardZ/YCOtle) -
,C� //35� S�SO Ls� �/���..s�.l,�; i�� y�C�
Pason auUwrized bY duy ezeculed Power d Attomey w by IC G7.1-12-.07
Address of a�Ahor¢ed persa+ (number a�M streel cd}: sfate.
Oate (rtimfh, tlay, yea�