HomeMy WebLinkAboutMortgage_Sanders��,� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
�' FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
j• State Fortn 43709 (R6I5-06) � �
� Presaibed by Department at Local Gwemment Finance
INSTRUCTIONS: MAR 3 IF��rk
To be filed in person or by mail with lhe CountyAuditor ot the counfy where fhe property is locafed.
Filing Dates: 1) Real Properiy: Dunng the 12 months befo�e June 11 of the year the deduction is to be e� e. �
2) Mobile Homes assessed under lC 6-1.1-7: Between January 15 and March 2 oI the year the�uch� to be effective.
See reverse side /or additional instructions and qual�cations. G�BSON COUNTY AUDITOR
Tauing DistNd % /
U
� — I
Assessed value of real property as of
March 1, wrrent year �
I( no, what is his / her exad share of i
If ry�e o� record is different than t11a
restricfions on rever�� side)
Key number / legal
--� ,
�ti�
MoAgage / Contred ind
March 1, curtent year
of applicant,
of moRgagee or contrad seller
assignee or other owner or holder ot mortgage
of assignee (numberand sbeet, city, state, ZIP code)
If
Record number
Page number
as of I Is the a
ownef?
���
�
t the sole legal or equitable
❑ Yes ❑ No
with someone other than spouse, indicate with whom.
property
� Dra���cr NO..�.�UA..-.�.��.�r.�
C a 1" (i l�i 0 . . . . . . . . . . . . . . . . . . . . . .
�.UQ �/7� ��d . o0
Does applicant own property in any other I If yes, what counry? What Taxing Distrid?
county in Indiana?
approved in the amount of:
20 �Q_ 20
1
Signature
COUNTY AUDITOR
20 20 20
County Auditor
AI
Has lhis deduclion been requested on
property for wrrent year? 0 Yes 0 No
20
Date
20
certify under the penalty of perjury lhat lhe above and foregoing infortnation is true and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 7, 20
Full residePt addr ss of apptipnt
� i i� 5a s i�u�su,�'le Ca� f�aa.k��i�
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
ofauthorized person