HomeMy WebLinkAboutMortgage_Coomer (8)�? °'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count ip
r,_ .. :; FOR DEDUCTION FROM ASSESSED VALUATION {�
" State Farm 43709 (RB / 2-07) _ "� �
�° ,.. � Presoibed by Departmenl of Local Govemmml Fi,unce
INSTRUCTIONS:
F�'m�l 3 2008
To be �led in person or by mad with the CountyAuditor o/ the county where Ure propeRy is located.
Fding Dafes: 7) Real Pioperty: Dunng the 12 months be%re June 77 W the year the deduc6on is to 6e eBective. /7 �
2J Mobile Homes assessed under IC 6-7.7-7: Belween January 15 and March 2 of fhe year the deduction is to be eR tive� �
See reverse side7aadditional instructions arrcl qualifications. GIBSON COUNTY AUDITOR
Applican� (owner m mnLacf buyer - s e 2sfnctims m reverse
aring DisUict Key num6er / legal tlesc
` l �
Pssessed value of 2al poperty as of Mart�h 1, anent year A4
a
If ro, whal is his / her erad share ol irrteresl?
rn recorA is
or tonllact
— rxv � � i n�= � � `Y
�e! Caniract iMeMedness unpaid as of A/arch i,
year
of rtroM1gagee or mnlract seller (rwm6er a�M sVeet. dry, sfale. and ZIP code)
Name of assgnee a oV�er owner or hdder of rnortgage
Address of assignee (mm�bu aM sGeeC city. slate.
wM sort�eme olher Ihan spouse. uWicale wiih whom.
Oces applican� own property in arry dher I If yes, what counryl What Ta�ring Dis4ict?
counry in Indiana?
❑ Yes ❑ No
Deduction appm+ed in lhe amoun� ol:
S��
Si9riaW re of Caunry Autlilor
zo I zo
COUNTYAUDITOR -
equivae owneR
�s ❑ No
properry in Question:
af Property� ❑ Mot�le Nome QC 61.
"/�7 _
Drawer NO.!�47:..��cl
Card NO. ......... ......
O.11 (3 3'3/, OCX�.�o�
zo zo _ � zo _ � _
Date (mmN. tlay, yea�
I I We certify under the penalry of perjury ihat the above and foregoing iniwmation is true and mrred and that the applinnts was / were a resident of
Indiana and owner of the aforemenamed property o� March 1, 20
�raUUe owne(slullname) /� Date (monlh, day, yea�
) �. 1% .r9 /".....,�,.t�� � - IZ.(��.
rasi9ent address o,fca�pplicant (numberand sGeet. cdy. sfa�nd Z!P oot
/.'Z.Z � Na.vw*-r„ c�-, /L�.: .c,,e
Persn� aulhrnized bY tluly enecvled Po.rer of Attortrey w by IC 61.1-12-.07
Address of aulhoraed persm (number arM sheet, cify. stale, aM ZIP code)