HomeMy WebLinkAboutMortgage_Robinson (6)��� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�a' FOR DEDUCTION FROM ASSESSED VALUATION
�: N� y• State Form 43709 (R6 / S-06)
� Resoibed by Deperiment of Laal Gwemrtrerrt Finance
INSTRUCTIONS:
Count Township Year
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DE�,��,2006
To be filed in person or by mail wrth the County Auditor of the county where the property is located.
Filing Dates: 1) Real Property: During the 12 months belore ,lune il of the year the deduction is to be e(iecfive a� �y+��
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the deduc66/i i�o df8 elfective.
GIBSON COUNTY AUDITOR
See reverse side fo� additional instnictions and qual�cations.
Applipnt (owner aontracf buye - s re ricfions on reverse side)
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Taxing Distri Key number / legal description Record number �
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�� Pagenumber ���
Assessed value oi real property as of Mortgage / Contra 'nd e ness u p' s of Is the applipni the so e� quitable
March 1, current year March 1, curr year � owneR ❑ s"�]]
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,
I( no, what is his / her exad share of interesl? If owned with someone other than spouse, indica h
If name on record is diiferent ihan fhat of applicant, indicate below: Is the property in q estion:
❑ Real Properly ❑ ortie QC 61.1-�
nme of mortgagee or conVad seller ,
Address of mortgagee or conVad seller (number and st2et, aty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and sheet, city, state, ZIP code)
Dces applicant own property in any other It yes, what county? What Taxing Distrid? Has lhis dedudion been requested on
county in Indiana? property for current year? � Yes ❑ No
COUNTY AUDITOR '
Deduction approved in fhe amounl of:
20 �� 20 20 � 20 20 20 20
iV
Signalure County Auditor Date
/ We certify under the penalty of perjury that the above and foregoing infortnation is true and correcl and that the applicanls was / were
� a resident of Indiana and owner of the aforemenlioned property on March 1, 20
Signature (owne/s (uli name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Full resi nt address of ap icant Address of authorized person
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