HomeMy WebLinkAboutMortgage_Walker/��STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
�j • State Fortn 43709 �R6 / SO6) �
� Presoibed by Department of Lonl Govemment Finance
wsrRUCnorvs: ,IUN 0 7 20�f� Man�
To be liled in pe�son�or by mail with the County Auditor of lhe county where the�property is /ocated.
Filing Dates: 1) Real Property: During lhe 12 months before ,lune 11 of the year the deduction is to,be eKecUve, �
2) Mobile Homes assessed unde� IC 6-1. iJ: Between January 15 and March 2 0l the, eaNtite �etl�oSon is to be e8ective.
See reverse side for additional instructions and qualifications. G!BSON COUNfiY AUBIficIP
or contracf
Taxing
Assessed value of real property as ot
March 1, current year
If no, what is his / her exact share of interest?
If name on
on
Key number / legal description Record number
�G�a�.��� �.o��� o�
Page number
0
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year owneR ❑ Yes ❑ No
than that of applicanl, indicate below:
mortgagee or contract seller
owned wifh someone other than spouse, indicate with whom.
l U �-1� !�1 °
Address of mortgagee or contrad seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
(number and street, city, state, ZIP code)
Dces appiicant own property in any other If yes, what county?
counfy in indiana?
coi
Deduction approced in the amount of:
Is the property
❑ Real Prope�
� V�rt,�. -
a�_.�.�G�
�,�n,����� �o
❑ Mobile Horrie pC 61.
iudion been requested on
wrrent year?� Yes� No
C; rd N''� FC l�l ���/ ��
�
20 D_�_ � 2� � I 2� P I 20 2�
County Auditor
20
20
We certiy under the penalty of peryury that the above and foregoing informalion is true and corred and that ihe applicants was / were
residenl of Indiana and owner of lhe aforementioned property on March 1, 20
(owners full name)
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
FuII resident address of applipnt Address of authorized person
�' �7� a E'. /f�U �U�