HomeMy WebLinkAboutMortgage_Hauschild.,.. R�n
/e, � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i�' FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
� .�J' State Fwm 43709 (R6l 5-06) , ; '' , . . - .
Presaibed by Deparimenl of Lopl Gwemment Finance
INSTRUCTIONS: ' File Mark
To be filed in pe�son or by mail with the CountyAuditor o( the county where the prope�ty is located. � � T 1 5 2���
Filing Dates: 1) Real Property: During the 12 months 6efoie June Il of fhe year the'deduction is to be effective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the �ac�Gon�� eBective.
See reverse side for additional instniclions and qualifications. GIBSON CO�NTY AUDITOR
Applicant^(owner or contract buyer � see
Taxing Distrid
Assessed value of real property as of
March 1, wrrent year
If no, what is his / her exact share
on reverse side)
Key number / legal description Record number
. c� �,� -�a �
Page number 4 p
' ^ ' ��. ol l
Mortgage / Contrad indebtedness unpaid as of Is the applicant, e sole legal or equitable
March 1, curren`t��year�� owne(J �❑ No
�
If name on record is difierent Ihan that of applicant, indicate
mortgagee or contrad seller
If owned with someone other than spouse, indicate with whom.
�e or contract seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of,assignee (number and street, city, state, ZIP code)
<
propeRy in quesGon:
❑ Moble Hare
Does applicant own property in any other If yes, what county? What Taxing District? Has this dedudlon been requested on
counry in Indiana? property fof u�rce-• -- � Yes O No
6 ���3
COUNTY AUDITO z o2 � a '
Dra���er ��•..........
Deduction approved in the amount of:
� 1� ,
Signature
20 �_
P
20 20 2G
County Auditor
CaYd ��• ..... . . ..........
We certify under the penalry of perjury that the above and foregoing information is true and corred and that Ihe applicants was / were
resident 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 �
person