HomeMy WebLinkAboutMortgage_Bigham��� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
4 FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
+ � Scate Fortn a3709 (RS / 4-03)
� �«.
PrescnDeG by Departmen� of Local Govemment Finance
INSTRUCTIONS: ��A � �
To be /iled in person or by mail with the CountyAuditor o7lhe county where the property is loca q
Filing Dates: 7) Real Property: Dunng !he 12 mont6s belore May 71 01 the year the deduction o b �akuE
2J Mobile Homes assessed under IC 6-7.1-7: Between January 75 and March 2 o/the year the deduction is to be eNective.
See reverse side for addifional instructions and qualifications. MAY 0'� 2��5
(owner o�
Taxing Distrid
buyer-see
Assessed value of real property as of
March 1, wrrent year
If no, what is his / her exact share
Key number / j�gal description
O(�-033�,7
Mortgage / Contrect indebtedness
March 1, current ear
� �00 a
name on record is different Ihan that of appliwnt,
of mortgagee or contract seller
below:
Address of mortgagee or contrect seller (nu�rloer and sfreet, city,
Name of assignee o r owner or ho de of mort g
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what countyl
coun�y in Indiana?
Deduction approved in the amount of:
20 20 O 20
P
Signature � _ _ _
GIBSON COUNTY AUDITOR �
Record number � C
l.�
� � Page number
npaid as of Is the applicant the sole legal or
owner? ❑ Yes ❑ No
I( owned with someone other than spouse, indicate with whom.
ZIP
What Taxing Disirict?
COUNTY AUDITOR
20 O q 20
P
County Auditor
Is lhe propeAy
❑ Real Property ❑ Mo�le Hane (IC 67.1-�
Has this deduction been requested on
property for current year?� Yes� No
�
20
We certify under the penalty of perjury that the above and foregoing in(ormation is true and correct and that the applicants was / were
resident of Indiana and owner o� aforementioned property on March 1, 20
Person authorized by duly exewted Power of Attorney
or by IC 6-1.7-12-.07
Full r' ident�ddrbs�o( applicant �Address of authorized person
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