HomeMy WebLinkAboutMortgage_Gieselman°°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION �
Slate farm 43709 (R8 / 2-07)
.�' �. � PresaDed by Depat�menl a Lod covemmen� Ff�ance
File Mark
iNSrnucnoNS: OCT 1 5 2008
To be filed in person or by mad with the CourrtyAuOitor ol fhe couMy whera !he propeAy is located.
Fding Dates: 1J Real Property: During the 12 monU�s before June 11 d the }rea� tAe deduction is to be eAective.
2) Mo6�7e Homes assessed eaMer IC 61.1-7: Belween January 15 and March 2 0/ the year the deduction is to bee$�tive.��
See reverse side /a additional insWctions and qual'Akafions. 0��
APpic�nt ( or wn(rad buyer�e res6imora m feverse sae)
_/ �.f/� �
A�ssed rdue o(leal lOpeM1y es of March 1. arrenl ymf Mortqage I C
. anrent year
If r �( � his / her enacl share af iMerest?
If reme m record is diBerenl Ihan that of appicanl, indimte below:
Nartre af mortgagea or canUacl sdler � � �-,
mongagea d oonVad sdler
� Name ot assgnae or W�s wvner «
� '��
IiraN own property in arry dher
InSana?
❑Yes ❑No
sfa(e.
�ate, and ZIP code)
If yes.
� 1� '� ���
as
Is Ihe applionl lhe sde legal w
If oh+�ed wilh sameone dher lhan spouu. udirate with whom.
COUNTY AUDITOR
�
i
P
� �� �
�"IaGe wnre/1
lYes ❑ No
�Is,Ih/� prope,ty in queslim:
L`aQteal P�operty ❑ Mobile Home pC &1.1
Has this tleduGion beai requested on propeny
(u airteM yeaR
❑ Yes ❑ No
zo
:�
Sigreture of �amly AudOnr CauntY Date (monN, UaY• Yee�
I/ We certify under the penalty ot perjury ihat the above and foregoing infortnation is we and corred and Uial the applinnts was I we2 a resident o( �
Indiana and owner of fhe aforementioned property on March 1, 20
e(ownels hAI name� . n Date (monfh. daY• Y��7
� A A
F�de ad� ess o� (number a�M street ', state. and IP
�
Person aWwraetl bY duN ���� Power of Atimrey or by IC 61.1-72-.07
Pdtlress of aulhoratd persm (num6er and s4eet aty, sfale, afM LP code)
Dale (rtanfh. day, yea�