HomeMy WebLinkAboutMortgage_Lashbrook (2)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS ear
FOR DEDUCTION FROM ASSESSED VALUATION '..{"
Slale Form 43709 (RB / 2-07) u �
�' ..�. � Presa3ed by DePertment d Loral Govemment Finance
' OC�i1�N�A2��
INSTRUCTIONS:
To be filed in person or by mad wifh the CourttyAuditor d the courrty where the property is bcated.
Fding Dates: i) Real Property: Dunng the 12 monMs be/we June 17 W Ne year fhe deduction is to 6e e/(ecfive. �p-y�,[ �,.. �
2J Mobde Homes assessed under IC 6-7.1-7: Behveen Januery 75 and Maich 2 olthe year the deduttiar is to ffe e/7e�ve.
Seeieverseside%radditionalinstrUttionsa�Mqual"rfications. GIBSON COUNTY AUDITOR
(amer cr wntrad b�yer - see �es4ictiais m reverse
�- l- l - -000. � 9�-oa 7
1, ai2nl ymr Abrtgage / ConVaQ indebledness unpaid as of March 1.
���� /Y.'�. �/ (
is his / hm exaci shara ot irrte,est7
If reme m remrtl is EiBerad Ihan Uat oi
Name of rtwri9agea ar conUacl
mor�gagea u wnfrad seller (numbef and a6ce4 dty. sfate. ard LP ca0e)
a dher o.vner or hdder ot martgege
assignee (rcaMer aM s6ee4 �: �ate.
Doas epplicaM axn property in airy olhrl
couMy in Indiaro?
❑Yes ❑No
DeOuclion appmved in Uie amwnt of:
2b p`l � 20
yes,
20
county?
VJhatTa�dng
COUNTY AUDITOR
� Si3o
ar equitade owrreR
❑ Yes ❑ No
spouse. indicate with whom.
Is the property in queslim:
❑ Real ProceM ❑ Mobile Hane
�c °�CnSS
� ✓'.J_V......_�.....�
� 1y3,10 q.°c
20 _ I 20 _ I 20
Date (mmfh. daY. Y��)
20
�m
� No
I/ We certify under the penalty of perjury that Me above and foregoing infamation is true and correc[ and fhat tlie appGqnts was / were a residenl of
Indiana and owner oi Gie aforementioned properly on March i, 20
Signa4ue �qwne/s fi6�^re) /� _ Date (monlh. daY. Y�A
�tnl address of a�w i�anl (number and s4ee1, stafe. and LP cvQe)
Pl W `t���l+�,c �v� �Rr�c��rt, .i,�
authorized 6y Euy enewled Power of Altm�ey ar by IC 61.7-12-.07
: oF aulhor¢ed pe�sm (number aiM streef. aty, state. aiM ZIP cotle)
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