HomeMy WebLinkAboutMortgage_Hall (4).r�•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n T s ip Year
_,, ., 4 FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fwm 43709 (R8 / 2�7)
•O�;y •� Presaibed by Depahment of �ocal Govemment Finance
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INSTRUCTIONS:
To be filed in person or by mail with fhe CountyAuditor o/the county wheie the property is located. � ��
Fding Dates: 7J Real PropeRy: Dunng the 72 monUrs be/we June 17 o/ the year the deduction is fo be e/tective. �
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 end March 2 of the year the deductiar is t�e69cSve
See reverse side lor addi6onal insWCtions and quali(cations. GIBSON COUNTY AUDITOR
Appl' (ownerormnfrad6uyer-see 'fion reyerseside
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Ta�d is4i Key number I legal desuip6on Remrd nu er Page number
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Assessed ralue of mal poperty as d March 1, amenl y�r Akutgage / ConiraC irWebled�ss unpaid as M Maich 7, Is Ihe apptipnt ihe e legal a equiUde owneR
artent year y 31 C O O
�> ❑Yes ❑ No
,�, whai is his I her ezad share of interest? If wmed with someone dher lhan spouse, indicate with whom.
If name m recwd is dAterent Ihan U�at of applicant, irWiple below: Is the property in 9uastion:
❑ Real Property ❑ Mobile Hwrie (IC 61.1
Name of mortgagee or COniraCl seller
Address of moAgagee w conVaa sef
Name of assignee w oU�er owrrer or 1
Address of assgnee (nwnber aM sVeeG city. sfafe. aM IIP code)
Dces applicant own poperty in any olher
couny in Ind'anal
❑ Yes ❑ No
Deduction apprwed in Ne amount of:
2Q � 20 _
SianaWreo� nlvAutlitnr .
I I'We certify�
Indiana an
�nalure (o �'s h
FWI re ' ant atldress
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Person au�honzed b�
'y�'1
Ir yas, what counry? whet rex
COUNTYAUDROF
20_ 20_
Caunry
the penalry oYperjury ihat the above and foregoing infwmation is tri
ot the aforementioned property on March i, 20
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andsheef. cify. stafe.
si.i-iz-.o�
of aulloraed persm (number arM sheeG city. s(ate. aiM ZIP mde)
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