HomeMy WebLinkAboutMortgage_Sweppy�" STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
-° i FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S«. j Slate Form 43709 (R4 / 70-01) . —+� ' �
� Prescribed Cy DeOarimen� W Local Govemment Finance E}..�
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INSTRUCTIONS: f t� 2 F�ile�}B
To be filed in person or by mail with the County Auditor of the county where the properiy is located�
Filing Dates: 1) Real Property: Dunng the 12 months 6e%�e May 11 o/ the year the deduction is to�re e/tect,ive.� � n n
2) Mo6ile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 of t�kWe �duchon is t�b`e�eflective.
See reverse side far additional instructions and qualifications. ' GIBSON COUhi r qUDITOR .
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Taxing DisUid // Key,rfujr�ber / legal description e Record number G6�
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Assessed value of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year March 1, current year owneR ❑ Yes ❑ No
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If no, what is his / her exacl share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicanl, indicate betow: Is the property in question:
of mortgagee or conirad seller
Address of � aaee or
of assignee or other owner or holder
street, city,
of assignee (number and st�eet, city, state, ZIP code)
Dces applicant own propeRy in any other If yes, what county?
county in Indiana?
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Signature _
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Dra�'ver�NO.....a9o:� •:
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What Taxing Distric[?
INTY AUDITOR
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�ounty Auditor
❑ Real Property ❑ Mobile Home (IC 61.1-�
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Has this deduction been requesled on
property for current yea(?� Yes❑ No
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Date
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/ We certify under the penalty of peryury that the above and foregoing infortnation is true and corred and that the applicants was / were
r resident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly exewted Power of Attomey
or by IC 6-1.1-12-.07
oi a�¢lipni �Address of authorized person