HomeMy WebLinkAboutMortgage_Neidiga•`.-r,-Q-�'^A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDIOESS Count Township Year
T�,�.. : 4 FOR DEDUCTION FROM ASSESSED VALUATION �� �
State Fortn 43709 (RH I 2-07)
'1 � Presaibed by Department of Lo�al Gavemmenl Finance
File Mark
�NSrRUCnoNS: SEP 1 2 2008
To be filed in person or by mail with the County Auditor of the couirty where the properfy is bcated.
Fding Dates: 7) Real Pmpelty: DuAng the 12 months be/ore June 17 of fhe year the deduc6on is to be eBecfive.
2J Mobile Homes assessed undei IC 64.7J: Beriveen January 75 and March 2 o(the year the de�i �is��ective.
See reverse side 7or addifional instrucGons and qualifications.
GIBSON COUNTY AUDI
Apqicanf (wmeror buyer -see res� "�ons on reve side) � ,
Tadig Di �ct Key number I legal deutiplmn Rttord number Page number ^
-/ - ax .5�57 -D �
value of 2al propaty as of MaN� 7. anent y�r Mortgage / Contracl indebtedness unpaitl as of March 1.
a��,�� �� i 9 9
y--�, what is his I her exact share of inleresl? I If wmed wi�h someone W
�
If name on recorU is tlif(erent than Ihat of applicanl, intlicate below:
Name of morlgagee or conVact el r
Address of rtartgac�ee or canUaG seiler (nu ber arrtl sVee(. oty, sfafe. ari0 ZIP code)
or hdder of mortgage
of assignee (mimber aiM sbeet, city, sfate. antl ZIP pode)
Oces applican� own property in any dher
counry in Indiaria?
❑Yes ❑No
DeduGbn approved in Ihe amaunl of:
20 O� 20 _
�
SignaWre of Caunty Auditor
0
Is ihe appfimnt Ihe
spouse.l
Is 1he pn
❑ Real
xe �ega� « equtaae wn,eri
❑ Yes ❑ Na
whom.
in question:
;rty ❑ Mobile Home QC 61.
.
— • . � ..�....
Dra�ver NO{•:: �••••••
` .. 3(�
�, � 7 . —
Ca►•d NO . .. .................. w�aem
— � �U� 199. o� ❑ No
[RQ�1:Y�L•l�l�
20 _ � 20 � 20
Dale (monlh. day, yea�
20
I/ We cerofy under the penalry of perjury tliat the above and foregoing infortnation is we and correcl and that the appiinnts was ! were a residenl of
Indiana and owner of Ihe aforementioned property on March 1, 20
�,naLUe (owners fidl name) .� �n • Date (monN. daY Y��
. �
resitlern address o( applicant (number ntl slreel. cdy. slate. ntl ZIP ootle)
� �305 ��ac,c�,a�`
Pawn auttror¢ed 6y duy exeated Pow of Attomey a by IC 61.1-12-.07
Address of aultra¢ed pera� (num6e� anO s4eeC cRy. stafe, arM LP mde)