HomeMy WebLinkAboutMortgage_Grubb (2)��� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
.,.«. ! StateFOrtn43709 (R6ISW) � � �
� Presvibed by Department af Loml Gwemmeni Firunce _
wsrRUCriorvs: MAY �e��07
To be filed in person or by mail wifh the County Auditor of the county where fhe property is located.
Filing Dates: 1) Real Property: Dunng tbe 12 months before June Il of the year the deduc6on is to 6e eflec�8,�1 �Q�,
2) Mobile Homes assessed under lC 6-1.7-7: Behveen January 15 and March 2 of the year the de��n is toxie effective.
See reverse side fo� additional instructions and qual�cations. GIBSON COUNTY ALIDITOR
Assessed vatue of real
March 1, current year
If no, what is his / her e
xin--1--�—�--4 cy
If name on record is dil
N�me of mortqaoee or
on
Key number / legal description
as of MoRgage / Contract indebtedness unpaid as of
March 1, current year
�OOO�rp
�e of interest? If owned with someone ot
i � lp'
applican
� n
Address of mortgagee or contract seller (number and streef, city, sfate, ZIP
Name
owner or
street,
Does applicant own property in any
county in Indiana?
F.��1�m
\
Signature
r oi mortgage
:ity, state, ZIP
It yes, what a
What
COUNTY AUDITOR
amount of:
20 �_ 20 20
i �
County Auditor
�rd number � �
� number � � /,
Is the applicant the soleiegal or equitable
awner? � Yes � No
spause,
❑ Real Property ❑ Motnle Home pC 61.
DI'�11'CC �T�. �.`W.-..�J..9.1�
C:11'(� �`� . .....................
�
Date
20
; YesU No
I/ We certify under the penalty of peryury that the above and foregoing infortnation is We and cortect and that the applicants was / were
s�deni oi Indiana and owner oT the aforementioned property on March 1, 20 .
_ na (owne/s (ull name) Person authorized by duly executed Power oi Attomey
�1 � (� . _ � � � � ��- or by IC 6-1.1-12-.07
oTauthorized person