HomeMy WebLinkAboutMortgage_Phillips (5)�'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' � FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�> J Stale Fwm 43709 (R6 / 5-06)
�•
Prestnbed by Deperimenl of Local Govamment Finaxe
To beRfrlued�in�person or by mail wdh the County Auditor of the county where the propeRy �at�. ��J ile arlc
Filing Dates: 1) Real Property: Dunng the 12 months before June I f of the yea� the deduction is to 6e eRec6ve.
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 0( fitf��'ea$,ti�§ ��Uon is (o be effective.
See reverse side for adddional insfruc6ons and qual�cations. �
�� �
Applicant(ownero�contract e�- stnbti onree� side) GIBSONCOUNTYAUDITOR
Taxing District Key number! legal descripti Record number h�
U
�- (`�0 ��-�. ��5 number aSaS
Assessed value of real pr erty as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year March 1, current year owner? Q Yes � No
- ( V ��
If no, what is his / her exact
If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
�e oi mortgagee � '-�ntrad seller �� �`�
\ ��
Address of mortg• O�.a `1 eI '\ �"her and stieet, city, state, ZlP
Name of assig� C'ar � O h \
� f,'� � /
Address of � �� ,S� .
Does applicant own prope.., i� . ! What Taxing District?
county in Indiana? ���
I
COUNTY AUDITOR
approved in the amount of:
20 ��
Signature
2� p I 2� � I 20 2�
P
County Auditar
❑ Real Property ❑ Mob�e Home pC Cr1.
property tor arrent
r'�i7
20
�
certity under the penalty of perjury that the above and foregoing infortnation is W e and cortect and that the appiicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or 6y IC 6-1.1-12-.07
person
,30� � �u L P2��c� b,.� s,., � �c,�