HomeMy WebLinkAboutMortgage_Weber (3)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
�+ �w J State Fortn 43709 (RS l a-03)
� PrasaiEed by Depanment of Local Govemment Finance
INSTRUCTIONS:
To be filed in person or by.mail witA the County Auditor o/ the county where the property is /ocated.
Filing Dates: 1) Real Property: During Me 12 months before May 11 0/ the year the deduction is to be eff��. `Z Q
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deductic
See reverse side for additional instructions and qualifications. �/ � f (
conhact6uyer-see
Ass�ed valu��6f real proF
Mar 1, cun�C� year
I( no, what is his / her exact
If name on record is differer
on reverse
Key numbeqlJ�gal description
GIBSON COUN7 Y
number
be eflective.
� V /'y�� M/�' � �� Page number
C�CJ �J
as of Mortgage / Contract indebtedness unpaid as of Is ihe applicant the sole legal or equitable
March 1, curzent year G 3�SU4 , owner? ❑ Yes ❑ No
(Il ��
�e of interest? If owned with someone other than spouse, indicate with whom.
of mortgagee or contract seller
Address of mortgagee or contract seller
Name of assignee or
applicant, indicate below:
and street, city, state, ZIP
er owner or holder of mortgage
mber and street, ciry, state, ZIP code)
uoes appucanc own prope
county in Indiana?
Deduction approved in the
zo
Signature
zo
Is the pi
❑ Real
L�' I
� 0�3 03/$
VCJJ?-�-f/t�
��3
�•
Counly Auditor
6 � GO�J• °G
Date
❑ Mobile Home (IC 61.
deduction been requested on
for curtent year? � Yes ❑ No
�
20
I/ We certify under the penalry ot perjury that the above and foregoing infortnation is true and correct and that the applicants was / were
,�esident of Indiana and owner of the aforementioned property on March 1, 20
�
S
or by IC 6-1.1-12-.07
of authorized person
-----------------------------------------------