HomeMy WebLinkAboutMortgage_Boling.A °^n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fortn 43709 (RB ! 2-07)
�9 f Presmbetl by DepaMnent of Local Govemment Finance
e a
INSTRUCTIONS:
To be lled in person or by mad wdh the CourrtyAudifor o/ fhe counly whera fhe piopr.rty is bcated. S E P 2 6 Z �� 8
Fding Dates: 1J Real Property: Dunng the 72 monU�s belore June 17 W the year fhe deduction is to 6e etfective.
2) Mo6iie Homes assessed under IC 61.1-7: Behveen January 15 and March 2 of Me year fhe deduction is to be eflective.
See 2verse side (a additional instructions arnd qualifications. �-7m �
^ o �a(�—
'�"artl(ON'fe 4" -s ���1� , fB1e.(s95'��/) I GIBSON COUNTY AUDITOR
Key rnmber / lega
of real pfopaly of Ma2fi 1, alrr�rt y�r
I If n�� is ha! her eracl share
1 If reme
seller
below
T3
7e / Corf
year ,
Address af mor�qagee w oonlrad seller (number arM s7reeC tity, state, end LP coCe)
Nartre oF asvgnee or alher owner w hdtlet of mortgage
Address of assigriee (rp�mber arid sbeet. tity. sfafe. and ZIP co0e)
�ess unpaitl as ot March 1, I Is Ihe applifant Ihe sde legal n equitahle owneR
�� ❑Yes ❑No
If owned with mrt�eme Wher Uan spouu, 'uWicate wilh whom.
Is U�e proper(y in queslion:
, ❑ R�I Property ❑ Mobjl� Hwrie (IC &1.
Dces aPP�icanl own property ii d Te�ting Disiric
cwnry in Inda�? �i /�
� Y� s�n 7
Drawer NO.v:�Q�•: �7..
, ROR
o�������,�� CarLd�NO........ ....
p� n S'�Ot L�'GNT�[!o �'$` j�� 20
Fo rw� qAj<A (�
Sio e o nty Audilnr �MY �
�
�
Has Utis dedudion been requested on poperty
tor a,rrart yean
� ❑ Yes ❑ No
20
20
I/ We ce�fy under �ie�penally of perjury tli ihe above and foregoing infamation is We and correct and that tlie applicants was / were a resident of
Indiana and owner �f Il�e afwemenfioned p on March 7, 20
�naWre lowners fiAl name) Date (monlh. OaY. Y��
�,q v, u� N� � k E'c_.r
� address of applicanl (ntim6er end streel. dty. state.
r�S� �u,.� L �
ihor¢ed by du y rxeated Power of At or by IC 61.1
4 aWnrized persan (nurs�ber aM s4r,�f. cdy. state, and L
day,yea�