HomeMy WebLinkAboutMortgage_Maxey.+� STAIEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Trnmship Year
FOR DEDUCTION FROM ASSESSED VALUATION
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S,.,. � Prrsmbetl by DepaMrent of local Go�emmexrt Firence
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wsrRUCnoNS:
To be fiied in person or by mad with the CourttyAuditor o/ the tourrty where the property is bcated.
Fding Dates: i) Real Pmpe/ty: Dunng the 12 months be/ae June 11 ollhe yrear the deduction is to be eBec6ve. FEB 2 � Z ��9
2) Mobiie Homes assessed urrder IC 67.1-7: Behveen January 15 and Marcfi 2 of fhe year the deduction is to be eftukve.
See reverse side /or additional rnsWctions arnd qualifltations. ` -
T" ' isUi ' Key nuinber / legal deaaiption
�, a - o�r-as- ac
(w�,�or��,,�ar.��m,.a.,�rny� M«+�
her exa�Y share ai'viteresl7
� If rome m remd is difte+enl ihan that of applicarrt, i�cate below:
� Name of mortgagee o� caniwct srJler
� nmress m monga9ae «mntrae seller (�wmber ara sbeeG dy, stafa.
a naa�. or m«,�
� nmess or assiyrue (rn�bar ane srree+. «ty. sfe�e.
Daes epplxaM own prope,ty in arry dher
cwrrty in Indura?
❑Yes ❑ No
oedw�� ��ed � me �«,m oe
�_ �_
Sigreture of Counry Auditor
e � under the penalry
In " a an E
Si
�.�dGm a ess of icaM (nu
Person aulhonzed by duly ecewted F
yes.
0
- boo. ba►-oao
iUad intlebtedrcess unpaid as ot March 1,
u o«ned wGh somerna
GIBSON COUNTY AUDITOR
�s me appucant u,e sae �ega� « ey�ritaae o«ner,
❑Yes ❑No
than spouse.
Is Ihe property in quastim:
❑ R�I Pioperty ❑ Mobile tbrne (IC 61.1
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lli':111'CI' l�i�..��! /
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� 1'�15, G�CO. � . .
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ion been requested on praperty
7
❑ Yes ❑ No
Date (m�mlh. dey. yea�
�
of pe�ury that the above and foregoing infortnabon is We and corred and tha[ tlie appGpnts was / were a resident of
1�ntioned property on March 1. 2p _
4
pelsan (num6er aM sheel, rdy. state, aM LP mde) ; .. _,
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