HomeMy WebLinkAboutMortgage_Garred (3)�n 4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
1�' = FOR DEDUCTION FROM ASSESSED VALUATION
`.. J State Fortn 43709 (R6 / SM>)
�• Presaibed by Depertmenl of Local Gwemment Finance
Coun Township Year
INSTRUCTIONS: FiJe
To be frled rn person or by mail wdh the County Audito� of the county where the p�operty is located. �V�/ai 2`� �
Filing Dates: i) Real Property: Dunng the 12 months 6efore June I f of fhe yea� the deduc8on is to 6e eflec6ve.
2) Mobile Homes assessed under IC 6-1.7-7: Between January 15 and March 2 0l the year thq.daduc�o be eflective.
O'� �See reverse side lor additional instructions and qualifications.
,., GIBSON COUNTY AUDITOR
orcont2ct bwer-
Taxing Dlstnct
Q� �(�2C1��.
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share oi interest?
If name on recortl is tlrtter
�e of mortgagee or cc
Address of mortgagee or
Name oi assignee or othe
tions on rey,erse sitle)
/�Q G��/
Key number / legal des ption /O�/ Record number
a�� /9/e��o���1� �o
Page number
Mortgage / Contract indebtedness unpaid as of Is the a
March 1, curjeryS.yqar owner?
that oi applicant, indicate below:
owner or holder of mortgage
city, state, ZIP code)
c me soie iegai or
Q Yes � No
If owned with someone oiher than spouse, indicate with whom.
state,
Is the property in question:
0 Real Pro�erry � Mohle Fbme QC 61.
applicant own property in any other I lf yes, what county? I What Taxing District? I Has this deduction been requested on
y in Indiana? property for current yeaf? Q Yes❑ No
COUNTY AUDITOR
2o�Z z� Dr:��rcr i\'O...a.�(,' r% zo zo 20
c���� ,vo. ...33y � Date
Signature • . . ��(���
� �'*L, • ' . . . .
� � ���
�We certify under tr,e N�� �...,, _, . ,nfortnation is true and cortect and that the applicants was / were
esident of Indiana and owner of the aforementionea prope�.Y .,,. ..._.ch 1, 20
�
Person aufhorized by duly
or by IC 6-1.1-12-.07
person