HomeMy WebLinkAboutMortgage_MarginetSi1i(
,� STATEMENT OF M A E
� INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
VALUATION State Form 43709 (1-90) Prescribed by the
��'�? State Board of Tax Commissioners
Instructions for filing:
To be filed in person or by mail with the County Auditor of the county where the NOV 13 2U00
property is located during the 12 months before May 11 of the year the deductio
is to be effective. See reverse for additional instructions and qualifications.
GIBSON COUNTY AUDITOR
Applicant (Owy�r or
- see restri�ions on reverse)
Key Number/Legal Description
SIIl'.t'�' I1
Record No.
No.
Ass�ssed�lue of re�1 property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of Mar 1, current year. equitable owner? O yes �] no
a
If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
of mortgagee or contract seller
of
Name of Assignee or
or contract seller
owner or holder of Mortgage.
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? O yes ❑ no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
� s� �-ps- ��3_
�� � _ U�bl �81�, �P�q R
G
a-9'��
� � Secretary of Board of Review Date
P
—1
I/We certify under penalty o( perjury that the above and foregoing information is true and correct and that ihe appli-
,�nts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
gnature (owners full name) Person authorized by duly executed Power of Attorney or
., �-ti.n _ _-�- (� _ �.,n _ � +� by IC 6-1.1-12-.07).
Full Resident Addr�s of A icant v Address of Authorized Person
P
.,,�n3 �J• WaSLnt�t— . , _,