HomeMy WebLinkAboutMortgage_Barrett`° R�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
- � FOR DEDUCTION FROM ASSESSED VALUATION
S / S�dte Form 43709 (Ra / t0-07)
,r.
��, Prescri�ed by DepaNnent of Local Govemmeni Finance
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor of the counly wheie the property is located.
Filing Dates: 1) Real Property: During the 12 months betore May 11 of the year the deduction is to 6e effect�(FR 2,rj 2�OZ
2) Mobile Homes assessed under IC 6-1.1-7: Belween January 15 and March 31 0/ the year the deduction is to be effective.
See reverse side lor additional instructions and quali�ca6ons.
_ GIBSON COW � Y �UDi70R
or
Assessed value of real property as of
March 1, wrrent year
an reverse
number / legal des�tion
) �� - 00 0 _-�
/ Contrad indebtedness unpaid as of
March 1, current year
0350
Is the applicant the sole legal or equitable
owneR ❑ Yes ❑ No
If no, what is his / her exad share of interest? If owned wilh someone other than spouse, indicate with whom.
If name on record is different Ihan lhat of applicant, indicate below: Is the property in question:
� R ❑ Mobife Home QC 61.
�me of moAgagee or conirad seller
,;
Address of mortgagee or contract seller (number and street, city, state, ZIP r �
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any
county in Indiana?
Deduction approved in the amount of:
20 �_ �� /� I 20 Q�
If yes, what county? � What Taxing Distrid?
COUNTY AUDITOR
20� 20 20
County Audftor
Has this dedudion been requested on
property for cunent yeaR� Yes❑ No
20
Date
201L
�
We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
esident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
person