HomeMy WebLinkAboutMortgage_Parker� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
' � FOR DEDUCTION FROM ASSESSED VALUATION
ti J StaiB FOrtn 43709 (R4 / 76-01)
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� PrescriDeO Dy DepaNrent ot Local Govemment Finance
INSTRUCTIONS:
To be filed in person or by mail wifh the County Auditor of the county where the property is located. �AY 2 20�3
Filing Dates: 1) Real Property: During the 12 months belore May 11 of the year the deduction is to be e/fectiv . q
2) Mobile Homes assessed under IC 61.1-7: Between January 15 and March 31 0/ the ye fhe deduction is,to be eHective.
See reverse side (or additional instructions and qualifica6ons. J
GIBSON COUNTY AUDITOR
Applican rorcont tbuyer- restri 'onsonrev rs side)
Taxing �strid ey number / legal description Record number O�
�� b ���� Pagenumber
Asses ed value real prope a of Mortgage / Contrad indebtedness unpaid as of Is the applicant the so e leg equitable
March t, curre ear 'March 1, cunent year � owneR ❑ Yes ❑ No
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If no, what is his / her exact share of interesl? If owned w' someone other than spouse, indicate wilh whom.
If name on record is different ihan tF�at of applicant, indicate below: Is the property in question:
❑ Real Properly ❑ Mobile Hane QC G7.1-�
�me of mortgagee or contrad seller ��
Address of mortgagee or contrad seller (numb and street, ciry, state, ZIP
Name of assignee or other owner or holder of mortgage �
Address of assignee (numberand street, city, state, ZIP code)
Dces applicant own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requesled on
county in Indiana? property for curtent yea(? � Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 � 20 Q(�_ 20 � 20 � 20 � 20 20
� � �
Signature County Auddor Date
�I/ We certify under lhe penalty of perjury thai the above and foregoing infortnation is true and correct and lhat the applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
Signature owners /ull nam Person authorized by duly executed Power of Attomey
Uor by IC 6-1.1-12-.07
ull reside address of applipnt Address of authorized person
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