HomeMy WebLinkAboutMortgage_Richardson (17)�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
s'� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
J State Fwm 43709 (R6l 5-06) � ��
� PreSaibed by Depertment ot Lofal Gwemmant Finance
INSTRUCTIONS: MARFHe Ma�JO�
To be filed in person or by mail with the County Auditor of the county whe�e the p�opeRy is locafed.
Frling Dates: 1J Real Property: Dunng the 12 months belore June Il of the year the deduc6on is to be effecti�e�9 ���
2) Mobiie Homes assessed unde� IC 6-1.7-7: Between January 15 and March 2 of the year fhe deductr�n is Io'be elfecfive.
See reverse side for additional instroctions and qualffications. GIBSON COUNiV AUBIi6F�
Applicant (owner or ntract buyer - s e re tri
Taxing District
�LCJ�/X� /iKiLt"�J
Assessed value of real property as of
March t, current year
If no, what is his / her exact share of interest?
on
Key number / legal description
�G i�a/ �5�ax�.�9
March 1, current year
If name on record is difterent than tha[ of applicant, indicate below:
:e of mortgagee or contract seller
Address oi mortgagee or contract seiler
/�
and street, city, sti
Name of assignee or other owner or holder of mortgage
Address of assignee (number and stieet, city, state, ZIP code)
Does applicant own property in any
counN in Indiana?
Deduction approved in the amount of:
r� � �i
�
as
Record number
number
Is the applicant the sole legal or
owner? ❑ Yes � No
0, Q� �
If owned with someone other than spouse, indicate with whom.
r IT yes, what county?
COUNT�
20 �_ 20 _
P
Counry Auditor
�`3D, Uvo
� � 73� 3
I/ We certiTy under the penalty of perjury that the above and foregoing infortnation is true and conect and that the applicants was ! were
�sident of I�diaga,�nd owne�T.the�foremc�ptioned property on March 1, 20
� Fuil�side� ad�s:
.1 �
�l �
or by IC 6-1.1-12-.07
Address of authorized person
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