HomeMy WebLinkAboutMortgage_Storckmans°'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count 7ovmship. Year
_ FOR DEDUCTION FROM ASSESSED VALUATION �
a FI
su�e F«m aa�os �rxs r zv��
�O �sw j R�rnbed by DeparU�rnt of Loral Govemment Firiance
Fil Ma�c
iNSrnucnoNS: JUL � �7 cUU8
To be fifed in person or by mail with the CountyAuditor o! the county where the propeAy is located.
Fdinq Dates: 7) Real Property.' Dunng the 12 rtronfhs be/ore June if of the year tbe deduction is fo be eHec6ve. �
2) Mobile Homes assessed under IC 67.1-7: Behveen January 75 and March 2 0l the year the deduc6on is��:aAeytf�
See 2verse side for additional insWctions a�d qualifications.
- GIBSON COUNTY aiinrcna
4pp' (owner w mnLad 6uyer - see ie:
Tadn Key
Psscssed vdue M real property as d MaNi
'�hal is his / her exacl share ot iMer�
If reme on record is tlif(erent ihan ihat of a�
Name of mortgagee or cantract sdler �
Address of mortgagee or mnUaC selter (nt
Name of assi9nee w aUret owrier or hdder
Add!¢55 01 SSSIpl180 (lNRIfIM 2/Id SL9Bl. O
�S'ans reverse sitle) }o �
� Li
i I legal desaiption Record numbei Page rwmber
-la�-ao- oo -a0�.3so-o� � aoo 8 ss
n¢nt year Motigage / Contra�t iMebtedness unpaid as of March 1, Is ihe app6pnl Ihe sole legal a eqititahle wme(:
aR��,�� � i P Q ,� �.
��r�-.rrr�-v /�� ❑Yes ❑No
can4 indirate below:
�er .4ieef. dty. sl
mwt�age
slafe, and ZIP code)
Does applicant wm property in arry other I If yes. whal
counry in Intliana7
❑Yes ❑No
Oeduction approved in Ihe
�
SignaWre of CaunlyAuditor
20 _ � 20
If o-m�ed with sameane oUier Ihan spouse,
� Is Ihe Droperty in quesUon:
�� v�(/O(� - ✓e�r c� 7-71 �
i
�,i��� ' Dra�i�cr NO;.:..:.....
�e� -- — � • ....
�..Cal;d,!\' �, + `�//.�`
�j� �c�./�� .4���
Whal Texing DisUicl?
COUNTY AUDITOR
�
Caunry
20
Has Uis tleduqian been
tor artml yeaR -
20 _
�estetl on property
❑ Yes � No
Dale (month, day, yea�
20
I/ We certify under the penalty of perjury ihat Me above and Foregoing infomwtion is true and correct and that tlie applinnts was / were a resident of
Indiana and ovmer of fhe aforemenUOned property on March 7, 20
��ide�it adtlress of appliraril (numberand s6eet dty, stafe, arM ZIP oode)
��% �_ /Sfl S ��'n�c c �o..} �N 4�6'
Person aulhwized bY duy erzeculetl Power oflLLtariey a 6y IC 61.1-12-.07
pasdi (numberandstreel.rl};slafe,
Dale (rtanlh, day, yea�