HomeMy WebLinkAboutMortgage_White (3).�* °'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
X.. r
FOR DEDUCTION FROM ASSESSED VALUATION � g �
Slate Fartn 43709 (R8/ 2-07) �
S,�� f Presmbed by Depa�menl of Local Govemmenl Finance
I�
�NSrnucnoNS: JUL � 8
To 6e filed in person or by mail with the CountyAuditor o/ the couirty where fhe pioperfy is located.
Fding Dates: 1) Real Property: DuAng the 72 months be/we June 11 of the year fhe deduction is to be effective. �,
2J Mobila Homes assessed under IC 6-1.1-7: Behveen January 15 and March 2 0l the year tlie deduction is ty���
See �everse side (w additional insWCtions and qualifications.
GIBSON COUNTY AUDITOR
Ta�slrid (i U� Kay mber / Iegal desaiption Rem�d n Page number
�v-�8-o�-io0-oo0.58 -oaa� a99�--
psse�d vdue oF real poperty as d Mardt 1, arresl y�r MMga9e / Corrtract indebtedness unpaid as of Marrh 1, Is Ne appG<ant ihe sde legal w equitade ovrt�e(7
anentyear � /OO
S ❑Yes ❑ No
I�hat is his I her exaG share ot interest? If owned vnth sameme dtier than spouse, irMicate with whom.
If reme on record is d'Aierent than 1ha1 of applicant, iMipte below: Is ihe poperty in question:
�I Property O Mobile Hame QC 6-1.1-
Name of mor(qagee oroontracl sdler /� �'J��
Address of morigagee or cmlratl seller (numbu aiM �reef. dty. slale. arid ZlP code) ' . _ '' '
Nartre of assi9rree w other oaner or holder of mortgage
Address d ass9nee (numbe` arM sGeet, dty. stafe. and ZlP a
Daes applicaN oxn property in arry dha If yes.
tounty in Inda�?
❑Yes �No
DeducGon
2b
SigreWre
amounl of:
20 _ 20
D��.�����►- �io.. o. �-...� q 9 Z- _
VJhal Tadng [ C:I f�C� �� Q. . . ... . . . . . —
...... �
lo
AUDITOR
20 I 20 _ I 20
Date (month. daY Y��)
20
I/ We certify under the penalty of perjury that the above and toregoing infortnation is We and mrrecl and that the applicants was / were a resident of
Indiana and ovmer of the aforementioned roperty on March 7, 20
������.t/ �.oare ndl . Da�e (mmfh, CaY. Y��
�ess of applicanl (numbei and s6eet city. state. and ZIP wde)
Esrsr G/9/niu'r�$'taacr, OwcNSr;/ic
d by duly ezeated Power of Atbmey ar by IC 61.1-12-.07
of aulhor¢e0 person (number arM shee( aty, s(ale. arM ZIP code)
r�A