HomeMy WebLinkAboutMortgage_Remer�,��� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
's' ; FOR DEDUCTION FROM ASSESSED VALUATION
! State Fwm 43709 (R6 / SO6)
��• Presm6ed 6y Depertmenl of Laal Govemment Finarice
INSTRUCTIONS:
Count Township Year
File Maric
To be filed in pe�son or by mail with the Couniy Auditor of the county where the property is located. MQR 1 � 2008
Filing Dates: 1) Real Property: Dunng the 12 months belors ,lune Il o/ the yea� the deduction is to be effective.
2J Mo6ile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 of the year the ded is to be effective.
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See �everse side foradditional instruc6ons and qualifications. � `� ""�
GIBSON COUNTY qUDITOR
Applicant (ovmer co ct b r- se 2 t •tions on reverse side)
Tauing Distrid Key number / legal description Record number �OO �
�✓'"' �(/����`^�J�`����.�-( %9enumber /� � %
Assessed value of real pr erty as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year March «enl year owneR ❑ Yes ❑ No
��50�
It no, what is his / her exacl share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is difierent ihan that of appticant, indicate below: Is the properiy in question:
❑ Real PropeAy ❑ Mo6ile Home pC 61.1-�
Te of mortgagee or conVad seller ��
Address of mortgagee or conVaIX seller (number and streef, city, state, ZIP
Name of assignee or other owner or holder of moRgage • _
� ,Drawer NO.v�dA.:. ���%
Address of assignee (num6er and st2et, city, state, ZIP code) � '
Does a licant own ro e '•' Gard \ 0.
pp p p rty in any other If yes, what county? ,_. ����������""' q
'.,: ; `� �en re uested on
county in Indiana? • `' ' - � � . , �; „ • �ar?� Yes� No
COUNTY AUDITOR
Deduction approved in the amounf of:
20 �9u 20� 20 20 20 20 20
( �
Signature County Auditor Date
' We certify under the penalty of perjury that the above and foregoing intormation is true and corred and that lhe applicants was / were
sident of Indiana and owner of the aforementioned property on March t, 20
Signature�wner /ull n ) Person authorized by duly executed Power of Attomey
/ J�� J� . or by IC 6-1.1-12-.07
F II resident address of applicant n Address of authorized person
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