HomeMy WebLinkAboutMortgage_Lancaster^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS coun Township vear
._ FOR DEDUCTION FROM ASSESSED VALUATION
• Stata Fwm 43709 (R71 / 609) $ �
S,,,� J Presrnbetl by Department of Lncal Govemment Fuiance , h
Fi M rk
wsrRUCnoNS:
To be filed in person w by mail wifh the Coun Auditw or Coun Recwde� of the coun whele the F� �� ��
a n n v�v�m rs ���. T C /1p
Fil'mg Dates: 1J Real Pmperty: Must file dunrg the }rear lor which the deducfion i5 soughL O�� Odu� WiR]itor
2) Mobde /Manufadured Homes lrot assessed as Real Properry: Must file dunng tM1e twelve (72) months
6e(ore March 37 0/ each year the deduction is sought. ❑ County Remrdu
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See 2verse side far addiLOnal insVUCtiDns and qualificafions. �' '�'""�
nppficant(owner a6uye�-seerestti�smrevarseside) ^ �^ GIBSONCOUNTY AUDITOR
n n . _
As�sea vdnm a pioperty as p
MarN 7, MeM u
� � .
rc m. what a nis / hr,� eract share ot interesi?
H name m n.md'p diRerent than Nat of app6can; indicate bebw:
Name oi �ee or conUxt seqer
«ca,aad
owner or twWer of mortgage
r�a
AECress of assignee (number aM sbee; r�ty, slafe. aM Z/P code)
Does ePd�nt ovm prope�ty in any other I If yes.
munry in Ind'ana?
❑ Yes ❑ No
zo i zo
I/ We certify under�e penalty of perj�at
owner I contract bu r of ihe atoremen � ed
s,niptawre�{,(mvner's hm
X./�IOA� a���t�� �
� 43as �, �k� �Sn�
Person auNOmed CY duty �ewteE Poxcr o(Atinney
PEEress of auUra'vN person (number and stree; ciry,
�_
Ne above an
Propertyon<
�V I — / ! �_
fness unpaid as ot Mortgaqa I Conbact inEeMeOness unpaid as of Is N�
dare of sppGcation kqal
H owned vriN someane dher ihan sP�e. indicate with xlmm
jtade amen
Yes ❑ No
Is Me p�operty in Ques6on: Mnualty Assessed _
❑ Real ProPenY ❑ ??�!!�h! � .
frn cunent yeaR
COUNTY AUDROR '
_ _ � _"""".---�—
Dra�ti•er i\'p,,, O���q/
....
Card i\'O. .. J��?j
..................
� iay,i3s.a�
and ZIP catle)
w by IC G7.1-t2-0J
3en rtQuesteE m p�aperty
❑ Yes ❑ No
20 _
�day�
i resident of Indiana arW
h, day, yrea�
h. daY Y�A