HomeMy WebLinkAboutMortgage_Abelli i�� STATEMENT OF MORTGAGE OR CONTRACT INDE'BTEDNESS
`i' = FOR DEDUCTION FROM ASSESSED VALUATION ,
. �,«. � Stala Fortn 43709 (R6 / 5-06) . . ' .
r=• � Resaibed by Deparimenl of Loral Govemment Finance
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INSTRUCTIONS:
To be �led in person or by mail with the County Auditor o/ fhe counfy where�the property is located. nCr �� 2007 ,
Filing Dates: 7) Real Property: During the 12 months 6efoie ,lune 17 0( fhe year the deducUon is fo bAk�ct .
2) Mobile Homes assessed under IC 6-1.7-7: Between January 15 and March 2 oI the year the de � t(qn is to be elfective.
See �everse srde for additional instiuctions and qualifications.
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GIBSON COUN7Y AUDITOR
(owner or conhac{'Quyer - see
side)
Key number / legal description Record number
0 %
a�a�C� �� a 6-bs - a8 3rx�-ool. Ys� P �mber 8�� �
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owneR '❑ Yes �'No ' �
no, what is his / her exad share of interest?
If nama on record is different than that ot applicant, indicate betow:
"'�me of moAgagee or conVad seller
,~ ��
Addresa of moAgagee or corrtraG seller (number and street, dty, s
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and stieet, city, state, ZIP c
Does applipnt own property in any other If yes, what co.
county in Indiana?
)educGon approved in the amount of:
20 20 �� 20
P P
If owned wifh someone other than spouse, indicate with whom.
Is the praperty in
S"�^eal ProP�+�Y
`
"ZIP• .
�-, � l�=
-Rl�a
�%1 OP C�1 �U
1 Mobile Home QC G1.1-�
�a on
❑ No
certify under lhe penalty of perjury that the abo vas / were
lent of Indiana and owner of lhe aforementione
ire (owners (ull name)
� ,�_ //0. _ .. �/., �,P� � a� by ic s-i.i-�2-.0�
of authorized person
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