HomeMy WebLinkAboutMortgage_Garrett (3)�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
�s / State Fortn 43709 (R514-03) . .
� PrescriDed by Depertment of Local Govemment Fina�e
INSTRUCTIONS:
To 6e filed in person or by mail with the County Auditor of the counry whe2 the property is located.
Filing Dates: 1) Real PropeRy: During the 12 months be%re May 11 ot the year the deduction is to 6e effeaitl�u� i, 4 ZQQ6
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is to be elfective.
See reverse side for additional insbuctions and qualiTcations. '�jJaO_ ��
� GIBSON COUNTY AUDITOR
Appticant (ownerorcontracf buy�}- skelestrictisns on
Dislrid
Assessed value of real property as of
March t, current year
„ IKey
J
V l I
March 1, current
If no, what is his / her exact share of interest?
If name on record is diHerent than that ot appticanf, indicate below:
of mortgagee or contract seller
Address of mortgagee or contract seller (number and st2et, city,
Name of assignee or other owner or holder of mortgage
Address of'assignee (number and street, city, state, ZIP code)
Record number O�
�O� •i �'- ' Page number � O
� Y�
indebtedness unpaid as of Is lhe applicant the sole legal or equitable
� � ownef? ❑ Yes ❑ No
� Q �
If owned wifh someone other than spouse, indicate with whom.
ZIP
s the property in questian:
❑ Real Property p Mobile Hortie pC 61.1-n
Does applicant own property in any other If yes, what counry? What Taxing Distrid? Has this deduIXion been requested on
county in Indiana? —�-� property for current year? � Yes ❑ No
� _ �
� ' y'„
- �........ .
couNn aur S-
G�
Deduction approved in the amount of: �, . (J
20 I� � 20 �_ 20 (i Q 20
P Q P
County Auditor
Ln" �/c'' � 20
- — �1�
Date
We certify under the penalty of perjury that the above and foregoing information is We and correct and that the applicants was / were
esident of Indiana and owner of the aforemeniioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
authorized person