HomeMy WebLinkAboutMortgage_Glover�i�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION
•' �' «. -y State Form 43709 (R6l 5-06) �
� Presaibed by Departmenl of Local Govemment Finance
INSTRUCTIONS:
Count Township Year
File Mark
To be filed in person or 6y mail with the County Auditor ot the county whe�e the propeRy is located. �� N �$ ZQ�]
Filing Dates: 7) Real P�operty: Dunng the 12 months before ,lune � 1 0! the yea� the deduction is to be efleclive. .
. 2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Ma�ch 2 of the year _deduction 's to be eKective.
See reverse side for additional instructions and qualifications. � �i(BCI ��
GIBSON COUNTY AUglfi§p
Applicant er or contrdct buy - ee restricfions on rever id
Taxing D trid Key number Iegai description Record number
�/ _ / '^� ^]�� � ��. �� I �/� r�) Page number
�O / �3 C�J (.aC
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is lhe applicant the sole legal or equitable
March 1, curcent year March 1, currenl year owne(? ❑ Yes ❑ No
D Wv ,
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom. _
If name on record is difterent than that of applicant, indicate below: Is the property in question: , .
O Real PropeAy ❑ Mobile Home (IC 61.1-�
me of mortgagee or conUact selier ��
Address of mortgagee or conVad seller (number and sheet, aty, state, ZIP
Name of assignee or other owner or
Ky����� ��r71.
Address of assignee (number and sh
��a5 ��
Does applipnt own property in any ott y? Has this dedudion been requested on
munty in Indiana? property for current yeaR� Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 �� 20 �� 20�Q� 20 20 20 20
P �
Signature County Auditor Date
We certify under lhe penalty of perjury lhat the above and foregoing information is true and corred and lhal the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
ign re s/ull name Person authorized by duly executed Power of Aftomey
or by IC 6-1.1-12-.07
F e' nt address oT appli nt Address of authorized person