HomeMy WebLinkAboutMortgage_Turpin (5)°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS vear
FOR DEDUCTION FROM ASSESSED VALUATION !I
State Farm r3709 (RB / 2-0� I
�6 � Rescnbed by Depanment of Local Go�emmeM Fiinnce
ArK `L ��A9&
iNSrnucnoNS:
To be fiied in person or 6y mad wrfh the CourMyAuditw d the cou�rty wAe/e the property is bcated.
Fding Dates: i) Real Property.' During the 12 monNs be/ore June 11 of fhe year the deduction is to be elfecSve. ��y/
2) Mobife Homes assessed �mder IC 6-1.1-7: Behveen January 75 end Mamh 2 0! the year fhe deducti�s f��
See reverse side (w additional insWctinns a� qualifications. GIBSON COUNTY AU DITOR
(awnei cv con7aci 6uyar - see resGicfior�n reverse
aoo�r �
is h's / her exac4
If reme m
�numb�i/legal desaiption � Reoord numher Page rwmber
�- o - - 30 a-oQ6. 6 aa � 71a�
+. �,rem r�r M«+easa i comraa u,deaea�ess u�aab as ot n�arcn �. is u,a �ucam u�e sae iayai a e�,i�aae wmen
arterrt year
5 ❑ NO
.l? wneC with sameone olher ihan sp�wse. indicate wilh whom.
L �'�'W�f/n�
Atldress of mortgagee or can4aQ sdler (nianber 4�: sfale,
Name of as99� d df�er awnar « hdAer �
Addr�s of assignee (�axnber and sGeeL dl
Does applicanl own P��NY in arry oiher
coun(y m Indiarp7
❑Yes ❑No
Deduction approveE in �he amamt of:
ZO 2b _
Sig�ture of Counry AudMr
Is Ne property in question:
�teal Property ❑ Modle Horne QC 61.1-7)
matgage
Dra��•cr NO...��. �.........
sfefe. aM ZIP wde) � i � .
, 1 I �/
IfyeS.whffimurtyt What C�� u�Q. p........�y�........ edonpioqeny
�I� r� �Q�. � Yes ❑ No
COUNTYAUDROR
20 _ 20 _ 20
��Y
_'�
Data (month. daY. Y��
20
I/ We certify under the penalry of perjury that the above and faegoing infortnation is We and corred and ihat the appGpnfs was I were a residenl of
Indiana and owner of ihe aformrentimed propeAy on March 1, 20
�^ �(owners fir� narre) \ A ` oa�e (mmm. dar. r��
cdY. stste. eM ZIP mde)
by duly erzewted Power o1 Attomey a 6y
Address of aulhorized persm (number and s4eeC aty, sfate, and ZIP wOe)
Dale