HomeMy WebLinkAboutMortgage_Lynch.a.-�"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS T ip Year
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FOR DEDUCTION FROM ASSESSED VALUATION
Stata Fatm 43709 (RS / 2-07)
�� 1 pr¢spibed by DepaNnenl of Lafal Govemment Firence
�eu
MAR
INSTRUCTIONS:
To be filed in person or by mad wdh the CountyAuditor o( the courrty where tha property is bcated.
Fding Dates: 1 f Real Propeity: During the 72 rtronths before June 11 d fhe year lhe deduction is to be eRective. �6� ��
2J Mo6De Homes assessed under IC 67J-7: BeAveen January 15 and Mamh 2 of fhe year the deduc6on is to be el/eEGve.
Sae 2verse side la addifional insWctions arM qualifications. GIBSON COUNTY AUDITOR
I Appican o er m m�trad buyei - see �pshictians m reverse sde) � r� l/% .
�'�� a��� i a �'r � -
ralue of real poputy as of Maich 1, arrenl y�r Morigage / C
arrenl year
his / her exad share of
It reme on record
iMiqte below:
Name of mortgagee or canlraG seller �/ �
Address af rtroM1gagee w mnlrad seller (numberand sbeef, dty, stafe,
Name of asvgriee or Wher owner rn hdder
Address of asvgnee
slafe, and ZIP mde)
Dces applicanl orn property in any olher I If yes,
county in Indiana7
❑Ye5 � No
Deduction apptoved in Ihe amaunl
�
Sy�Wre of Counry Audibr
p� � p- I 20
Remrd rwmber I Pace ��mber
- p' , p d -Od % " D0� �7
dness unpaid as of March 1, Is Ihe appfiqnt ihe sde legal or equitaMa o.mer
�n n ❑Yes ❑ No
If ovmed with mmeone olher Uian spouse,
❑ Mobile Home QC G7.7
- � � ��.�7 -
�Q�3:-,�: � ,.
�C���,el \O ' ry
�
� � � 00
- ��Cd,�'% • ;�'�Q �Q
� p/ilr� �
��
I 20 _ 20 20
Date (rnmlh, day, yea�
I/ We certify under the penalry of perjury Uiat the above and foregoing infortnation is we and mrred and that the applicanfs was I were a resident of
Indiana and ovmer of the aforementioned propeAy on March 1, 20
�„�..e� �ar<en���..ai n Dalei�N.daY.Y��
Person
addrrss oF
sfafe, alM ZIP oo0e)
of auUroraeO person (number antl street, aty. slate.
Date (rranth, tlay,