HomeMy WebLinkAboutMortgage_Orr� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
�. / State Fortn 43709 (RS / 6-03)
�M
P�escnbed by Dapenment of Local Govemment Finance
Coun Township Year
� �
1� •� i
�TRUCTIONS: N O V 1 ���2M�`
� be filed in person or by mail with the County Auditor of the county where the property is /ocated.
Filing Dates: 1) Real PropeRy: Dunng the 12 montbs before May 11 0/ the year fhe deduction is to be effective.
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 oI t Ayear the dedu�wn is to�be e� ctive.
See reverse side for additional instructions and quali�cations. �` �!«� "
GIBSON COU.I i 1 nUDI70R
nppucant( er rcontractbuy
�
Taxing Distri
iJ (y
Assessed value of real property
March 1, cunent year
see
of
If no, what is his / her exact share of interest?
��-�Q-19-ao3-��.�
If name on record is difterent than that of appl.
of mortgagee or contract seller
of mortgagee or contract seller
on reverse
Key number / legal description I Record number �?
J
G�1 _ Page number ��
��
Mortgage / Contract indebtedness unsaid as of Is the applicant the sole legal or equitable
March 1, current year �� 6(J owner? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st�eet, ciry, state,
Dces applicant own property in any other I If yes,
county in Indiana?
20
Signature
the amount of:
�/(v�iZi7
s the property in
■ ' - . ' •,._ ,
dame �-� V �
)ocument # ��� g � 9 5� QOC�
�ate 9 _ i4 -03
Bank `c�,,:,,� �'-rS,`�"`.' f�°�tbZ
r� • -�i
/ I �
Counly Auditor
20 ��
r
❑ Mobile Home (IC 61.
:n requested on
ar? � Yes ❑ No
20
I/ We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
or by IC 6-1.1-12-.07
Address ofauthorized person