HomeMy WebLinkAboutMortgage_Seaney`°�° � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
° FOR DEDUCTION FROM ASSESSED VALUATION
S � Slate Fortn a3709 (R4 7 70-07)
Prcwibed Dy Department of Local Govemmen� Finance
�M
INSTRUCTIONS:
To be filed in person or 6y mail with the County Auditor o/ the counfy where the property is located. MAY 2 R 2��2
Filing Dates: 1) Real Property: Dunng the 12 months 6eto2 May 11 of the year the deduction is to be eflective.
2) Mobile Homes assessed under IC 6-1.1-7: Befween January 15 and March 31 of fhe ye he deducti n i o 6e e cti .
See reverse side fo�addifional insbuctions and quali�cations.
GIBSON COU� TY AUDITOR
Appticant (ow r or contra 6u er - see stridions on reverse side)
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Taxing Di rid Key ber / legal description Record number
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/, �/ Q _ �O �-� /� �� Page number
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Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owneR ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different ihan ihat of applicant, indicate below: Is the property in queslion:
❑ Real Property ❑ Mobile Home (IC 61.1-�
e of mortgagee or conlrad seller n
L.
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Address of mortgagee or conVacl seller (number and stree city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and st�eet, ciry, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing District? Has this deduction been requested on
county in Indiana? property for current year? � Yes❑ No
COUNTY AUDITOR
Deduc[ion approved in the amounl of:
20 _� 20 O 20 20 � 20 �� 20 �_ 20 ��
o�a-- p-r�reo� {� t� P
Signature County Auditor Date
We certiy under the penalty of peryury that the above and foregoing infortnation is true and corred and that the applicants was / were
resident of indiana and owner of the aforementioned property on March 1, 20
-ignature (owne s ull name) Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
F II r�/ t address of�lipn � � Address of authorized person . -
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