HomeMy WebLinkAboutMortgage_Rexing (4)a°q STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun hip
FOR DEDUCTION FROM ASSESSED VALUATION } �
Sfate Fortn 43709 (R8/ 2-07) �t /
�' yw � Prasrnbed by Depat�rtient of local Gaeemment Finance
��� �
lNS7RUCTIONS:
To be filed in person or by mad wrth the CourttyAudifor nt the courrty where the p`operty is lorated.
Fdtirg Dates i) Real Properfy: Dunng fhe 12 monMs before June 77 of the year the deduclion is to be eflective. � (Q
2) Mobile Homes assessed under IC 61.1-7: Befween January 75 and March 2 of the year the deduc6on is to 6e efl��
See reverse side /a additional instructions a� qualificafions. GIBSON COU �TY AUDITOR
t
Aodicam (awnei or mnh�s! 6wu iseare��s m reverse side)
� Key number / legal desaiption Remrd num Page m�mber
— 3 —3�-A�a.(��oa.Se (a�
,e of real poperty as d Maich 1, aarent year Mwlga re�Vact� ed�ss unpai0 as of March 1, Is Ihe appfipnt ihe sde legal w equitade wme/1
ILRCfI� ^ �
��j�j ❑Yes ❑ No
his / het ezaQ share af iMerest? . If wmed with mmeone dher �han spouse, i�cate wiih wham.
If reme m recaU
Name
seller
�'�
Address of mortgagce or mntraa seller (number aM stree4 oiy. �ate, aM
Name of asvgnee or alher_ox�r or hNrw..r.....,......___ '� �
Address of assignee (min. �� /'� � �O � � �
RE����
courM1y in Intl�ara'!
❑'
Deduc�ion approved in �he �..__.......
20� 20_
SigraW re af Counry Autlilor
a8- ��� 8
:�:L�
�at Tacing �isirid?
.-...JITOR
2p 20 _
CouMy
Is Ihe property in questlon:
❑ Reai Pmperty ❑ Mobile Home QC 61.1-7)
Has ihis dediMion been requesled on propeNy
(a avenl yeaR
❑Yes ❑No
i.=i�
Dale (�rpnih. day, yea�
20
I I We certify under the penalty of perjury that the above and foregoing infortnation is We and cortecl and tha[ the applicants was I were a resident of
Indiana and owner of the aforementioned property o� March 1, 20
��awre (own hn� na ) ��/� ��� ozte (m«,m, dar. r��
� /� � ��s��lv"'� a— �' �% %.
�adent address o( appliranl (number and stre - stafe, aiM LP codej
� �i 9.f9 S'�> �Y) F %�,.,.�� �Z,�f- ��1/ S'763 s
ezewled Paver of Attariey w by IC 61.7-
Address of aNMr¢ed person (num6eraM sheef, cif}; sfate, aM Z1P wde)
�ate