HomeMy WebLinkAboutMortgage_Bullock.! "^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tow�shi Year
_� FOR DEDUCTION FROM ASSESSED VALUATION �
State Fortn 43709 (R8 / 2O7)
�' �� Presrnbed by Department of Local Govemment Finance
�NSrnucnoNS: pp�����2008
To 6e filed in person or by mar7 with Me CountyAuditoi of the county where the pioperty is located.
Faing Dates: i) Real Pioperfy.' During the 12 months betore June 77 of the year Ure dedut6on is to 6e elfec6ve. ��
2) Mobiie Homes assessed under IC 6-7. 7-7: Between January 75 and March 2 of the year the deduc6on is to be�.
See reverse side fo! additional ins6vc6ons a� qvalifications. G�gSON COUNTY AUDI70R
nt,o� i� mnLn��CI� SeiX l/ D/7 ....reNerse sidj) . Q
/ YGsC.�
d �I
Key number I legal desaiption
��-�i a S - �foo �
of Mardi i, cwrenl year Mwigage / Coniracl iM
nirrenl year „ �
��
If .�, what is his / her exacl share of interest?
If ,��...a on record is diRerenl than ihal of applican4 ��ic
Name of mortgagee or cmtract seller /� `�_
/ . T
(..�!/t-G
Address of mortgagee or cmUad seller (num6u ard st�
Name af assignee or alhel a.vrier m holder of mortgage
Address of assgriee (numberandstreet, city, state, aM
Does applicaM ovm property in any other
counh � �ndiana?
❑Yes ❑ No
Deduction approved in lhe amount oE
Fb7
SignaW re of Counry AudMr
0
sfate,
ZIP code)
d 3�' -D a-/
paid as of March 1, Is �he
)O� �
Ii wmed wM sameme other �han spouse,
Rem�d number Page numbrl
�o $ �IYD
iFpnt Ihe sde legal a equitaNe o.mer
❑Yes ❑ No
Is ihe property in question:
❑ Real Pfqperty ❑ Mobile Home (IC 61.1
A
If yes, what county? Whal Taxing DisUicl? Has �hs detl�x7im beeri requested on property
ro. a,� y�n
. _ _ .___Q Yes_ ❑ No
` ^
COUNTYAUDITOF : D�•a�ti,e1• �iO. //�/j�(�,;�1�`'-
O:�ll.:lJ �
20_ 20 : C.'lI�(� ��� . .....................
Couny
I/ We certify under the penalty of perjury that the above and foregoing infortnaUOn is true and correU and fhat the applicanLs was / were a resident of
Indiana and ovmer of the aforemenUOned property on March 1, 20
..�e..e i„�...�e�� e��.,�,..oi _ . Daie Immth, daY. Yead
itlenl address af applicanl (number and stmel, cify, sta(e. arrd ZIP code)
�a�� s asa � P�; �«�.. �
Pason aWMr¢ed by duly enecuted Power of twney a by IC 61.1-12-.07
person (num6erarM sfree( aty, state,
Oate (mm�fh, day, yea'