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� � '�' �
.s�"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Ta
�,,. _ FOR DEDUCTION FROM ASSESSED VALUATION Ut� 2` Z008
State Fortn 43709 (RB / 2-07)
�°�; � Presvibed by Department of Local Govemmenl Firunce
��ra�-� a��"EJe Mark
INSTRUCTIONS: (J� V
To be (led in person orbymad with the CountyAuditor o7the couMy wheie the propeAyis located. GIBSON COUNTY AUDITOR
Fding Dafes: 7) Real Property: Dunng fhe 72 months be/ore June 11 07 the year the deduction is to 6e elfective.
2) Mobile Homes assessed under IC 64.1-7: Aehveen January 15 and March 2 of the year the deduc6on is to be eflec6ve.
See reverse side for additional inst/uctions arM qualifications.
(owner or mnt� buyer - see�reslrjoCSons m reverse see)
Key number / legal tlesaiption
properly as af Marfh 1. anent y�r I MMgage / Contract
♦ . . � w _ � QIR2lll Y2dir �
C
ng
recwd is ditterenl than that oi applicam, irWinta balar.
Name of mortgagee or
—/=.x,c� >_ L, �
Atldress of mortgagee or mnlracl seller (num arM strsef, tity, 9sfa, aM
Name of asegnea w other owner or hdder of mortgage
Adtlress M assignee (in.m6er eM sLeeC city, stafe. end ZIP ootle)
ooes aPpicam own p�openy in any aner �r yes, wnal cw,my7
courriy in Indiana?
❑ Yes ❑ No
un�pa"M as ot Malch 7,
T.
Remrd number
Year
Is �he applimnt Iha sde lagal w equitade owne/1
❑ Yes ❑ No
spouse, indicate with whom.
Is Ne property
❑ Mobite Home
/ ' ��___�F� � -� —
/!�0 t��Lfi
�B' .� /!�
��.3U �%� � x��r
i — .__ � No
� COUNTYAUDROR
Deduction approved in lhe amount of:
20 �_ 20 _ 20 _ 20 _ 20 _ 20 _ 20 _
�
SigreWre of Countylwtlibr Caurrty Date (month, day, yea�
I/ We certify under Ihe penalty of perjury that tlie above and foregoing informa6on is true and mrred and that the applicanis was I were a resident af
Indiana and owner oi the aforementioned property on March 1, 20
na��wne/s INl.name) Date (rtronth. JeY Y��
sident a ress of applicaM (numbe d sfreet. d(y. stefe. and ZIP mde) mQ�1� n� q
, � g S F � TN b � P�O, Q�-z31�, �o�.�� N�
Person aulhorized by duty executed Pwier of Allpney « by IC 61.1-12-.07 Oate (monfh. day, yee�
AtlOress af aulh«¢ed person (number and stree(. ciry. sfate, arW LP roQr)