HomeMy WebLinkAboutMortgage_Oneal�� °� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
'�s' : FOR DEDUCTION FROM ASSESSED VALUATION
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Presaibed by Department ot Local Govemment Finance
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INSTRUCTIONS:
Count Township Year
File Mark
To be filed in person o� by mail with the County Auditor ol the county where the p�operty is located. Q�� 1 � Z�� �
Filing Dates: 1J Real Property: During the 12 months belore ,lune 17 of the year the deduction is to be eflective.
2) Mobile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 o(the year fh��ti��o be eflective.
See �everse srde for additional instrucfions and qualifications. GIBSON COUNTY AUOITOR
Applicant (owner or contract buyer - see resMctions on reverse side)
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Taxing Dislrict Key number / legal description • ecord number
• a a� -o
• Page number
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Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant e sole lega or equitable
Maroh 1, wrtent year March 1, wrrent year � owneR s❑ No
If no, what is his / her exact share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
eal Property ❑ Mobile Home QC 61.1-�
e of moRgagee or contraU seller
Ad�ess of mortgagee or contrad seller (number and street, city, state, ZIP ,
Name of assignee or other owner or holder of morigage /� �
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Address of assignee (number and street, city, state, ZIP code) � -�
Does applicant own property in any other If yes, what counry? Wh C,���'Q'US�/ ��A'/v� � ����uested on
counry in Indiana? �-Z'/� � "� � � !es❑ No
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COUNTY AUDITOR �_S i
Dedudion approved in the amounl of: S�7
20 20� 20 20 20 20 20
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Signature County Auditor Date
�' We certify under lhe penalty of perjury thal the above and foregoing information is true and corred and that the applicants was / were
residenl of Indiana and owner of the aforementioned property on March 1, 20
Signatur ners /ull name) Person authorized by duly executed Power of Attomey
C�% or by IC 6-1.1-12-.07
F I resident address of applicant "� Address of authorized person
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