HomeMy WebLinkAboutMortgage_Ready^•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun'
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: FOR DEDUCTION FROM ASSESSED VALUATION
� � State Fartn 43709 (R11 / 6-09)
�' y�. � PfeSUibeA Ey Department of Local Govemmenl Finance
STRUCTIONS:
o be filed in person or by mail with the County Auditor or Counry Recorder o/ Ne counry where the property is located.
Filirg Dates: 1) Real Pmperty: Must frle during the year for which !he deducUon is soughf.
2J Mobile / Manulactured Homes not assessed as Real Property: Must !le dunng the 1weNe (72) months
before March 31 ot each year the deduction is sought. �
See reverse side for additional instrucGOns and qual�cations. �
Fwm Ned wtth:
O I � Nl4�hAuditor
County Recorder
C '�. _ _ .
nppGmm(owreror _buyer-seerestrirl�mrev�sesde ^ � GIBSON COUNTY
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Assesse0 rdiue o( poperq as d Ab�(qage / ContraG "v�CebleCness unGaid as ot Mortgage / Contra�Y mEehtedness un ' a d Is ihe ePP�^i the stle
Mard� 1, anmt year Mardi 7, artent yrar tlate of aDP��^ iepal w epuitade oxne(.+
❑ Yes ❑ No
tl m, what is ha / tcer e�a share of intemst? It wmed with someone other ihan sCa+se. Ind'xate with wMm
Nan
Name of rtartgagee a mntrarl seller
Address o1 rtnrtgagee or mntrad seAer (number aM sbee{ ciry, stare, aM LP code)
Name of assignee w Wher ovmer or fmlder of rtortgage
Aearess ot assig�e (numDer aM streeS �Y• srare. ard: '
Does apptkant wm Woperty in any oNer 1
Yes LJ No
�eoucoon appmvco m me amounc or.
2� _ 20 I 20
Sg�atuee of Counry Audiiw
Is Me property in QuesOOn: Mnua�y Assessed
I,]RealROperty QlumuallyPssesSed
Mobile Home fIC 61.
0
� �`dedWm Oeen re7uesteG m p�operty
Dra�ver i\'O...o�).`. ❑ Y� o
cat�a ��io. .. 3`��
............
� —l�I����,SCi
� i Zo
I/ We certi(y under the penalry of perjury that Ihe above and toregoing in(ortnation is true and mrtect and iha[ Ne applicant is a resident of Indiana afM
owner f mntrad buyer of ihe aforemen[ioned property on date application is filed.
U?6'7v
61.742-0]
Pdtlress ot a�nlror'vetl person (number and slree; ciry, stare, and LP code)
Date,mmtA. d2Y Y�?� _.. ..