HomeMy WebLinkAboutMortgage_Critser�°a STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
s�e F�,,, aa�os �aa r z-0��
�' „� r Resrnbed bY �Partmmt W Local Govemmerrt Firiance
INS7RUCTIONS: IYlIY'V� ZOOH �
To be filed in person or by mad with the CouMyAuditorW the courtty whe2 the propeAy is bcated.
Fding Dafes: 1) Real Proper(y: Dunng the 12 months before June 17 0/ the year the deducbon is to be eflective. �,(��
2) Mobile Hames assessed under IC 6-7_7-7: Behveen January 75 and March 2 0! the year the deducfion is to be f� '�.F
See reverse side for additional insWctions and qualifications. U
GIBSON COUNTY AUDITOR
-SEB
Key number / legal desuip6on
�a� oZ�O-/l- /�_�i
of mal popaty as MaN� 1. ctarent y�r MoNga9�
/ her ezact share M irrteresl?
difierera than ihat of applicant, i�mte below:
v -oo �- o a 7
Coniract uWebledness unpaid az of March 1.
` 1o25�7OC�
IF onned with sonieone olF
NartreofmorigageeorconUactsHler / �� i/ �
�� �/
//
nddress of monqas� a��a seller (numbrs and sheec dty, stafe, z�a code)
a hdder of morigage
AMlress of assgnee (rambe` aM sheet, dtY. siate.
Dces applicarq own
counry in Indu- � �
i�
�M ��
Drawer NO. 4�1L1:g .'.......
Deduction appr �
Card NO. ...rJ.. � �� .........
�°�- �ia�BaG.°-
of Counry nuaMr
What Tadng DisUicl7
AUDROR
20 _ � 20
. Record numb
Is �he applinnl ihe sde
spouse, indicate wi�h wF
Page mimber
! �
❑ Yes ❑ No
Is �he property in question:
❑ R�I Pioperty ❑ Mobile Home pC 6-1.
Has Utis deduction
fa aRenl yea/t
20
uesletl on pioperty
❑ Yes ❑ No
Date (manlh, eay, yea�j
2�
I/ We certify under the penalty of perjury ihat the above and foregoing infortnafion is We and corred and that the applinnts was I were a resident of
Indiana and owner of ihe aforementioned property on March 1, 20
inaLiralr�wners fiAI name) ,. . Date (rtronfh. day, yea� .
�ferd address of appliranl (number and s6eet cify, stafe. an0 ZIP mde)
9y w- 7s s PRTtilcETon/ �N, ����o
,
au�iwr¢ed by duy eneated Power of /LLtorney w by IC 61.1-12-.07
person (numberarMSVeeLcky.sfate,andLPwOe)