HomeMy WebLinkAboutMortgage_Ashby, �..,
i i� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
`\i' � FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
`� State Fortn 43709 (R6 / 5-OG) � � � ' "
� Presaibed by Department of Local Gwemmen� Finarice �� �
INSTRUCTIONS: �ifeGvta`�k8 Z00%
To be filed in person or 6y mail with the County Audilo� ot the county where the property is located. . .
Filing Dates: 1) Real P�operty: Du�ng the 12 months before June 11 of the year the deduction is to be eflective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 of the year the deduc�i�.��'o ��ctive.
GIBSON COUNTY AUDITOR
See �everse side (or additiona/ instnrctions and qualifrcations.
orcontract buyer- see restrictions on reverse side)
Taxing Distrid
arz ��3��-c�-J
Assessed value of real property as of
March 1, current year
what is his / her exacl share of
KQ'j/ number / legal description
a�-� 9-�8-3�3-00�.
/(oS- O��
Mortgage / Contred indebfedness unpaid as o
March 1, wrrent year �
g� yov
If name on record is dif(ereni than that ot appticant, indicate beloH
of moAgagee or conVad seller -
Address of moAgagee or conVact seller (number an st2ef, city, .
Name of assignee or other owner or holder of mortgage
of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what counry?
wunty in Indiana?
approved in lhe amount of:
20 0}� 20 ��
� n
Signature
Record number � - O 7
Page number 7�5, /
7"
f Is the applicant the sole legal or equitable
owneR � � ' � Yes" �'No " "
If owned with someone other than spouse,
, ��
�(e, ZIP -
What Taxing D
COUNTY AUDITOR
20 20 20
County Auditor
Is the property in
❑ Real ProcerN
3te with wh6m.
stion:
Mabile Hane (IC Cr1.1-
��/vEE c AsNay -
�7- 70Sy
NwN.;�y ." '_
20
Date
20
on
] No
certify under lhe penalty of perjury that the above and foregoing infortnation is true and corred and ihat the applicants was / were
lent of Indiana and owner of lhe aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
resident address of applipni O Address of authorized person
1�3 �E r�c_uc t� � �f���eG� _„y