HomeMy WebLinkAboutMortgage_Smith (2).t.�* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
x�-.. _., FOR DEDUCTION FROM ASSESSED VALUATION
' Stale Fam 43709 (RB / 2-07)
�O iew � ���� �' �Partmenl of Local Govemmen� Finance
�NSrnucnoNS:
To be fi(ed in person w by mad witA the CountyAuditor of the county where the property is locafed. Zp08
Fd'a�g Dates: 1) Real Properfy: Dunng the 72 months be/we June 77 0/ the year the deduction is to be eflecGve. /�''(; � s
2f Mobile Homes assessed under IC 64.1-7: Behveen January 15 and March 2 0/ Ihe year the deduc6on is fo�b'e`/lec6ve_
See reverse sid� additronal insWcfions arrd qualifications. ,_�J ��
iu.,
npplirant
r-se on rsesde) ` � TY AUDITOH
GIBSON COUN
ey num6er / lega desaiption Remrd number Page number
- a -� -�oo-� . i -oa oo � a �� �
of March 1, anenl yaar Abrigage / ConVacl indeWedness unpaid as of rU 1, Is ihe apptipnt Ihe sde legal u equitable ovmeR
arteM year \
�OOOV ❑Yes ❑ No
af interesl? I( owned with someane dher Ihan spouu, cdicate vrifh whom.
Ihat of applican4 ��dipta �elow:
Name of rnortgagee or conUaU seller
Address at rtartgagee «oonlraa selier (i
Name of assg�e a W�er oaner w holG
Aadress of assignee (rxanber and sheet,
Does appliwnl ovm properly in arry dher
county in Intliana?
❑Yes ❑ No
Deductian appmvetl in Ne amount of:
zo c� zo
Sigreture at Counry Autlilor
J/3
ier and sfreef. dty, state.
^�9�
#� a Z/P mde)
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I( ves. whal w
zo _
' t Taxing
COUNTYAUDROR
20 _
ca,��Y
Is Ihe property in quesUon:
�al Ropedy ❑ Mobile Hwne (IC 61.1
requested on prope,ty
_-- i
Dra���er NO a,o.o�,;. Z 3103
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CF•id NO . .....................
I/ We cerlify under Ihe penalty of perjury that Ne above and foregoinq infwmation is We and mrrect and tliat the applic�nts was I were a residen[ of
Indiana and owner of fhe aforementi ed propeAy on March 7, 20
��Wre (owne�s /Wl name) f� Dale (mmih. daY. Y��
applicaN
mde)
Power of fLLlomev w hv IC G7.7-12-.07
Address of au�Id'¢ed persa� (number aM sfieel, aty. stafe. aM
day, yea�