HomeMy WebLinkAboutMortgage_Gordon,i �'�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
j\c ; FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
`�:... .dl State Form 43709 (R6 / 5-06)
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�. Presaibed by Depanmeni of Locai Govemment Finance
, INSTRUCTIONS: ��� �a�
To be filed in person o� 6y mail with the County Audito� of the county where the property is locate ,
Filing Dates: 1) Real P�operty_ Dunng the 12 months before June I7 0! the yea� the deduction is e
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15�and Ma�ch 2 of the year the deduction is to 6e elfective.
See reverse side for additional instructions and qualifications. � U N 1 1 L���' �
Applicant (owner or
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Key number / legal description
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GIBSON C
Record number
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AUDITOR
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Assessed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is lhe applicant the sole legal or
March 1, current year March 1, current year owneR ❑ Yes ❑ No
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If no, what is his / her exad share of
If name on record is different than that of appiicant, indicale below:
of mortgagee or contred seiler
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If owned with someone other than spouse, indicate with whom.
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Address of mortgagee or contract seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sfreet, city, state, ZIP code)
Does applicant own property in any otha•�
county in Indiana?
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Signature
s the property ir
❑ Reat Property ❑ Mobile Home QC 6�1.1-
�at wunty? What Taxing Distrid? Has this deduction been requestetl on
property for curtent year? Q Yes ❑ No
COUNTY AUDITOR
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County Auditor
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Date
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' We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was 1 were
residenl of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of aulhorized person