HomeMy WebLinkAboutMortgage_Carnahan���� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
s• = FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�+'«. �J State Fwm 43709 (R6I5-06) � � �
� Presaibed by Department af Local Govemment Finance
INSTRUCTIONS: FEB �y,S,��O$
To be Tled in person or by mail with the County Auditor of fhe county where the property is located.
Filing Dates: 1) Real Properiy: Dunng the 12 months befoie ,lune 11 of fhe year the deduction is to be elfectiv �Q��+!�"�,
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the yea� the ��n is to(lSe elfe tive.
See reverse side /or adddional instiuctions and qual�catrons.
GIBSON COUNTY AUDITOfi�
(owner or
Taxing Distrid
Assessed value of real
March 1, current year
If no, what is his / her exad
er- see restnc o on revers �i e)
Key number / legai descripp
�ao -000.
as of Mortgage / Contrad indebte
March 1, current year
inierest?
name on record is difterent ihan that of applicant,
of moRgagee or contrad seller
Address of mortgagee or contrad seller (number and s
Name of assignee or other owner or holder of mortgage
assignee (numberand stieet, c
Does applicant own property in any other
county in Indiana?
)edudion approved in the amounf of:
20 �` 20 i�_ 20
p P
below:
Record number
Page number
unpaid as of Is the applipnt ihe sole legal or
owneR ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
state,
�'�"�^�LIJ�t' li��� ��i w—' `cc'7,
S���y
oG-sGa9
,..,,.,., , .,��......
20
County Auditor
�
Is the property in
❑ Real Pmperty ❑ Mobile Home
Has this dedudion been requested on
property for cunent yea(? 0 Yes � No
20
Date
20
certify under the penalty of perjury thal lhe above and foregoing informalion is true and corred and that ihe appliwnts was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
resident add(�ss of applic�p� _ _ IAd�ress of authorized