HomeMy WebLinkAboutMortgage_Crabtree (2)/�� § STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'' = FOR DEDUCTION FROM ASSESSED VALUATION
'e , ! State Fortn 43709 (R6 / 5-06)
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� Presaibed by Department of Lwzl Gwemmeni Finance
Count Township Year
INSTRUCTIONS: File Mark
To be �led in person or by mail with the CountyAuditor of the county where the property is located. MAR I 1((jf;b
Filing Dates: 1) Real Property: Ounng the 12 months before ,lune f 1 0l the year the deduction is to be ei(ective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o/the year f�-�eductlon�to be eflective.
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See reverse side for addftional instiuc6ons and qual�caUons. GIBSON
COUN7Y AUDITOR
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Taxing Dist '�d �G/�
7%( l/�'
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Assessed value of real property as of
March 1, current year
If no, what is his / her exad share of interest?
If name on record is different than that
mortgagee or contrad seller
Address of mortgagee or conVaG seller
Key nu�gal description
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MoAgage / CoMrad ii
March 1, current year
below:
Record number
Page number
as of Is the appli�
ownef?
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t the s le legal or
❑ Yes ❑ No
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If owned wilh someone ather than spouse, indicate with whom.
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street, city, state, ZIP
Name ot assignee or other owner or holder of mortgage
Address of assignee (number and street, aty, state, ZIP
Dces applicant own property in any other I If yes, whaf ��.^� ^ --'— -- ng Distrid7
counry in Indiana? --
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Dra��'er NO. �.7'•��O
Deduction approved in the am�
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Signature
Card NO . .....................
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Couniy Auditor
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❑ Real Property ❑ Mobile Home (IC 61.
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Has this dedudion been requested on
property for wrrent yeaf? 0 Yes� No
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certify under the penalty of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
leni of Indiana and owner of the aforementioned property on March t, 20
Person aulhorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
person