HomeMy WebLinkAboutMortgage_Moorman�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
s' = FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
_ / State Fwm 43709 (R6 / SO6)
� Presaibed by Depariment of Laal Govemment Finance �
1 1
INSTRUCTIONS: File Maric
To be filed in person o� by mail with the County Audito� ol the counfy where the propeRy is located. MAj' 1$ Z0�]
Filing Dates: 1J Real Property: Durtng the 12 months before June f1 o/the year lhe deduc6on is to be e/fecUve.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 75 and Ma�ch 2 of the year fhe ded�G'on is to be effective.
See reverse side foi additional instiucUons and qualr�catrons. �'"u' � y
� �/
GIBSON COUNTY AUDITOR
(owner or cont2ct 6uyer -
DisVict
� �
Assessed value of real property as of
March 1, current year
restrictions
Key number / legal
March 1, current year
��o,0aa
If no, what is his / her exact share of interest?
��---� �--14 - ao� -ool. �s
If name on record is difierent than that of applicant, indicate
of mortgagee or contract seller
Address of moRgagee or contract seller (number and
Name of assignee or other owner or holder of mortgage
���,,,� „�,,,,�, 3
�ge number �/
.7
unpaid as of Is the applicant the sole legal or equitable
owner? Q Yes � No
If owned with someone oiher than spouse, indicate with whom.
city, state, ZIP
Address of assignee (numbe� and sheet, city, state, ZIP code)
Does applipnt own properiy in any otherJ �+ •- �� d county? What Taxing DisNct?
counry in Indiana� -
- 3 g y..l
—�. �,-a,vcrNO.�•�•:••...
. COUNTY AUDITOR
20
�....
CaCd��•'•��••.:... `
,.r -�
� ' - 20 �
� � J � I
Signature
�i
County Auditor
20
.. ..._ ,,. _�_.., ... -,---°... �
❑ Real Properry O MoW1e Hwne pC Gt.'
property for wrrent year? U Yes�J No
20
20
We certify under the penalty of perjury that the above and foregoing inTortnation is true and cortect and that the applicants was / were
�sident of Indiana and owner of the aforementioned property on March 1, 20
executed Power of Attomey
or by IC 6-1.1-12-.07
ss of applicant Address of authorized person
� S �i O � � , ��c� ?'�`�, �„ 2