HomeMy WebLinkAboutMortgage_Boyle`ry�, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�°� : FOR DEDUCTION FROM ASSESSED VALUATION
� � State Fwm 43709 (R3 / 10.00)
Prescnbed Dy State Board o1 Taz Commissioners
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Instructions for filing:
To be filed in person or by mail with the County Auditor of the county where the property is
located during the 12 months before May 11 of the year the dedudion is to be effective. See
reverse side for additionat insirudions and qual�cations.
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Count Township Year
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NOV 13 ��ark
GIBSON COL'NTY AUDiivN i
Applicant ow erorcontFdctbuyer-sge2strjctions.�2vers�nhslde) ^ �
l Gl/) ti �. �%� u W IV M1.L`. �
Taxing Distrid Key number / legal descnption Rewrd number t
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_�\/'`n n,. n l V I�^�� r Page number n/
6 � lM� �' �-�" �
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is lhe applicant the sole legal or equitable
March 1, current year Marc�current year owner? ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
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If name on record is different than that of applicant, indicate below: �
of mortgagee or ntracl selier C��
Address of mortgagee or ntre seller (number and street, city, sfate, ZIP �
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own real property in any If yes, what county? What Taxing Distrid? Has this deduction been requested on
otner county in Indiana? � property for wrrent year? ❑ Yes L7 No
COUNTY AUDITOR
Dedudion approved in the amount of:
20 �� 20 20 20 jL� 200 (e 20 � 20 ��
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Signature � County Auditor Date
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•�e certify under the penalty of peryury that the above and foregoing information is true and correct and that the applicants was / were
�ident of Indiana and owner of Ihe aforementioned property on March 1, 20
Si natur�.,(owners 11 name) � Person authorized by duly executed Power of Attomey
fj or by IC 6-t.t-12-.07 �
uil resident addr ss of applicant �` p� Address of authorized person
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