HomeMy WebLinkAboutMortgage_Hyneman (2)"� R"'A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�
�i`�= FOR DEDUCTION FROM ASSESSED VALUATION Coun Townshi Year
": .. . J Siate Form 43709 (R6 / 5-06) � � . . .
�,•�.
Presai6ed by Depariment of Lopl Gwemrtrent Finance �
INSTRUCTIONS: ' QCT 1 �i��Mark
To be tiled in person o� by mail with the CountyAuditor ol the county where the propeAy is located. ,/
Filin Dates: 1 Real Pro e Dunn fhe 12 monlhs before ,lune 11 of fhe ear the deduction is to be e� Ka'��
9 ) P �Y 9 Y ,�tly�`� � �
�� 2) Mobile Homes assessed unde� lC 6-7.1-7: Between January 15 and March 2 0l the year �he dedfrctfp�d��t�F�//ective.
See reverse side fo� additional instructions and qualifications. GIBSON COUN
(ownei or contract 6uy,er - see
Taxing Distrid � '
.,�- .,:
�*�"' .
Assessed value o( real property as of
March 1, currenlyear
16 no, what is his / her exad share of interest?
name on record is different than that
of mortgagee or contrad
Address of moAgagee or conlraG seller
t�ons on rev rse side)
� � �.X-�
Key numb r/ legal de 'ption
�6:/8;- /3 - yoY,-:oo,o. -
��9-va6 F
Mortgage / Contrad indebtedness unpaid as of
March 1, current year
���'Q� ,
indicate below:
.,...,�,.,.,.., �o0 7
� number S� /
�
Is the appliqnt the sole legal or
owner? , ❑ Yes Q No
If owned with someone other ihan spouse, indicate with whom.
street, city, state, ZIP �
or other owner or holder of mortgage
Address of assignee (number and street,
❑ Real PropeAy O Mobile Horne
Drawer NO.�%Q�.:.(as��
CardNO . ......... ...........
code) �'I�CJ ��!�1e— —
9'.5.�, G�JO• —
Does applicant own property in any other If yes, what county7 What Taxing Di ____. o o__ __ _ i
county in Indiana? I propeM1y for current yeafJ O Yes O No
approved in the amount of:
20�� 20�`-�
� P
Signature
COUNTY AUDITOR
20 20 20
County Auditor
FI�]
20
We certify under the penalty of perjury lhat lhe above and foregoing informalion is true and correct and lhal ihe applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
executed Power ot Attomey
or by IC 6-1.1-12-.07
Address of authorized person