HomeMy WebLinkAboutMortgage_Etcovitch.•°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
. FOR DEDUCTION FROM ASSESSED VALUATION
Stale Fartn 43709 (R8l 2-07)
�' ,sw 1 pr�vibed �y Departmenl of Local Govemmenl Finance
INSTRUCTIONS:
To 6e filed in person or by mad with the CountyAuditor W the county whe2 the property is bcated. J U L O� Z 0 0$
Fdmg Dates: 1J Real Property: Dunng the 12 months be%re June 77 07 the year the deducGon is to be eRecfive.
2) Mob�7e Homes assessed under IC 61.1-7: Behveen January 15 and March 2 0/ Ihe year fhe deduction is to be eNec6ve.
See reverse side for edditional insWctions a�d qualificafions. `--}�; �
p �!
Appirant(ownei dbuyer-seereslricfiansonrave/seSid GIBSON COUNTY AUDITOR
v.�..., n:�..;.. ra..�.�.,,b. i i�� .ac.�ie,�'v.n Remrd number Pa9e mmiber_
� (f V�/p(' (J� � pc
❑opaty as d Martl� 1. w2nl y�r Mortgage / Contrad intlebledrress unpaid as o/ March 1
ainent year / �. ��
is his / her exacl share
If owned vri�h someone
If na'me m rec«d is dillerart ihan ihat ot applicarrt, indiote belo.v:
Nameofmortgageeoroonlractseller �
�
Address of rtaM1Bagee a oonlrad seller (iwm6er arM s6ee4 aN. sfafe, arrd
Name of assigrree or oV�er owner w hdd
Address of assignee (mimbet arM sfreet,
Dces applicant o.m prupe�y in a�ry olhm
counry in Indiana?
❑ Yes � No
Deduction appmved in lhe amwnt of:
Csf
SigriaW re af Counry Audiior
0
martgage
Dra��cr NO..��Ct.:J�a��
I ` t .
C:11'(1 �� . .................0 ..
��5��- � � s� �
� --� �
Counry
Is ihe appGpnl lhe
❑ Yes ❑ No
spouse,
�s Ne property in quesUOn: .
❑ Real Properly � Modle Home QC 61.7
Has Ihis deduction bcen
ru. a,rrent yPan
20 _ � 20
uestatl on property
❑ Yes ❑ No
Dafe (monlh, day, yea�
y
I/ We certify under Ihe penalty o( perjury that the above and foregoing information is we and correct and thal the applicants was ! were a resident of
Indiana and owner of fhe aforementioned property on March 7, 2b
�..�n�.e i,,,.,.�e.t Fa� �<..n� Daie immfh. daY y��
(number and sfreef. dty, state. and ZIP cotle)
�lu (yd ppwe� o{pA�pmay ur by IC 61.1-12-.07 Date
2�-E 0 Z t,� (0 2, S
pasan (num6eraM�c((eeLcdy,state,arMLPcode)