HomeMy WebLinkAboutMortgage_Chandler (3)�-�"n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS T i Year
Sc,... __ FOR DEDUCTION FROM ASSESSED VALUATION
S�ale Farm 43709 (RS I 2-07)
.�� �.. •� Presrn'bed by Deparlmenl ol Local Govemmenl Firence
1��
INSTRUCTIONS:
To be frled in person or 6y ma�7 wdh the CountyAuditor o/ the county where the property is located.
Fding Dates: 7J Real Propedy: Dunng the 12 monfhs belae June 77 of the year the deduction is to be el/ec6ve. �/ ,Q�,
2) Mo6ile Homes assessed under IC 6J.7-7: Behveen January 15 and March 2 0l the year fhe deduc6m is to b�Cflectiv�'
See reverse side (or additional insGuctions arM qualifications. GIBSON COUNTY AUDITOR
buyu: see resfriclionsAn reverse
ricl . Key numMr / legal desaiption Reoord number Page number
.wc,c�� 6 -/a-ob -yo/-ooD.733 -oa-8 ,��� b
alue ot real popaty as d March 1, anent year Mwigage / Contract iMebtedr�s unpaitl as of Mamh 1, Is Ihe appGcant Ihe sde legal a equiUde ovmeR
anent year
Q (� ❑ Yes ❑ No
is his / ha ezact share of irrierest? � If owned wilh someone olher �han spouse, indicate wiN whom-
If name m record is diRgeM ihan Iha�
Name of nartgagee or contract
of rta�tgagee or canlract selier (number aM
assignee a other w:ner or holder o( mortgage
Address of assignee (m�m6ei arrd stieel.
Daes applicant own property in a�ry dner
counry in Indiana?
❑ Yes ❑ No
Oetludion appmved in the amounl of:
�
Sig�Wre of CounryAUdiior
�
0
tity. sfate, aM
If yes, what wunryl
za _
Is ihe property in 9uestion:
❑ Real Roperly ❑ Mobile Hane (IC G1.1-7)
Drawer NO.,°Z v � � % / (�
' Card NO.
�, .....................
couNrr /y9� �.a o, w
20 � 20
Counry
zo _
'.letl on pioper�y
� Yes � No
yea�
rzr,
1 I We certify under [he penalty of perjury that Ne above and fwegoing infortnation is We and corteG and Nat the applicants was ! were a resident of
Indiana and owner of the afwemenboned property on March 1, 20
�ra4uefownpfs(iAl nartre) /1 f� /�1 Date (/�fh. tlaY. Y��
ot applicant (numbe�and sUeet. cRy. stafe. aM��;' �wde) -
�\4�-�X-u6� ��(. l�n w
tluy exeated Power of Allomey or by IC 67.7-12-.07
Address of aulMrrzed persm (�umberaiM slreet crty, slafe,
Dale (rtpnN. day, yea�