HomeMy WebLinkAboutMortgage_Bunch.r..='� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n sh Year
7; ._ � FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm 43709 (R8/ 2-07)
�6�y„ � Presaibed by Department of Local Govemment Finance
File ark
INSTRUCTIONS:
To be �led in person or 6y mail with the CountyAuditor of fhe county where Ne property is located. � �
Filing Dates: 7) Real Property: Dunng the 72 monfhs be/ore June 77 o/the yearthe deduction is to be e7lective.
2J Mo6ile Homes assessed under IC 6-L 7-7: Aehveen January 75 and Maroh 2 o/the year the deduction is to �//�Gv
See reverse side Ior addi6onal instruc6ons and qualifications. GIBSON CUUNTY UDITOR
ar conNad b�yer - see iesfnc1iPns on reverse side)
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sessed walue of 2al popary as d MarU 1, aurent year Alortgage I ConVact indeWedness unpaid as c� `�=-�h �+- - _.Is ihe.applimnt Ihe sale legal a equitaMe own
ainentyear — — -
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, what is his / her exaa sliare of interesR If owned wM s I/, �� ��' /� A�/�^� �i
i�J lJt� ✓ t� /�r
name m record is dA(erent �han Ihat of applicanl, indiple belw::
ame of mortgagee orcontracl seller � D� tirsE L
Ad�ress of rtartgagea a mnUact seller (num6er aM sUeef. dy, sbfe, and ZIP code)
Name of assigrree w aher owner or Iroltler ot mortgage
Adtlress M assgnee (number aM sGeet. dty. sta(e. and ZIP aode)
Doas aPdicaM own property in any other If yes, whet county?
courriy in Indiana?
❑Yes ❑ No
Deduction apD�'� � �e amount oF:
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ot
Whal Tezing C
COUNTYAUDROR
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I I We cert�nder the penal� perjury Uiat ihe above and fwegoing infortnation is true
Indiana an owner of the ator mentioned property on March 1, 20
i re e/s lull name K'^ � � �/�
I 1' ��/�\�/" �
0 rasideni adtlress of applicant (number end sfrael. cdy. stete. aM ZIP code)
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I Persan aulhonzetl by duy
person
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Power of Altnmey or by IC 61.1-12-.07
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