HomeMy WebLinkAboutMortgage_House.a °'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fortn 43709 (RS / 2-07)
S �� PresaibeC by DepaM1menl oi Local Govemmenl Finance �
ie a
iNSrnucnoMS:
To be fiied in person or by mad with the CountyAuditor of tAe county where fhe pioperty is located. Q P R � 2 �� 8
Fi7ing Dates: 1J Real Property: Dunng the 12 months before June il 01 fhe year the deduction is to be elfective.
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 2 of the year ffre deducUon is to be eflective.
See reverse side !w additbnal insWCGons arW qualifirations. �� �Q�
Appicam(a;,vngr�mn6artbuye�-seeresLic6aisonrevermsda) �� , � n GIBSONCOUNTYAUDITOR
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Asessed ralu¢ of r¢al propaty as of March 1, artent year Mortga9e / ConVatt i`We6tedness unpaid as of March 1, Is Ihe appfi�nl lha sole legal a eq�ritade owrie(.�
arteM Year � _l � �es
❑ No
I���hat is ha / her exacl share ot iMerest7 If owned wi�h mrriea�e oiher ihan spouse. uWicate with wlwm.
If �me on recwd is diRerent Nan Ihal
� of morlga or sdler
�
ndar�s oi nqanee w��a seu�
�r��.���nca
arM s6eel. dty. sfate. arM ZIP code)
w hdder of morlgage
assignee (nurMer arM sVee1 dty. 9afe,
Does applicaM own property in arry dher
�� � �����
❑Yes ❑ No
apprwed in �he arnamt of:
I 1 • � 1 �l�
ZIP wde)
`� ' ys 5!/.
If yes, whal caunry? � .�
iDra���cr \0.�....�........
i /
��. Card N0 . .....................
�" I �" � , 2�— I 2�—
��Y
Date
question:
y ❑ Mobile Home (IC 61.
been requested on pro{'eerty
❑Yes ❑ No
20 _
I/ We cerUfy under the penalty of perjury that the abrne and fwegoing information is We and cortect and Uiat the applicanls was / were a resident o!
Indiana and owner oi the atorementioned property on March i, 20
SignaWre(owne/sh/Iname) � �
Date (mon/h. daY Y��
by duty
andsUeef.ciq state,arMZIP
Pwrer
Adtlress of aielor¢ed person (number arM shee4 aty. s(ate, and ZIP ootle)
(mmN. daY.Yean