HomeMy WebLinkAboutMortgage_Davenportie � STATEMENT OF MORTGAGE OR CONTRACT INDtHI'c�h�ESS — r
'�i' �= FOR DEDUCTION FROM ASSESSED VALUATION . G�unt Township Year
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� �� J State Form 43709 (R6 / SO6) � � . �
Presai6ed by Oepartment of Local Gavemment Finance
INSTRUCTIONS: MAY �e�1��07
To be filed in person or 6y mail with the County Audilor of the county where the p�operty is located.
Filing Dates: 1J Real Property: Dunng the 12 months before June 11 of fhe year the deduction rs to be efFecfi�7ja ,Q
2) Mobi/e Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the dedu�on is���ctive.
See reverse side foi additional instructions and qualifications.
pIBSON COUNTY
Appllcant (owner or ontract 6uyer - see restnctions on reverse sidej
O � �� .L
T'n islrid Key number / IegaFde
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Assessed value of real property as of Mortgage / Contract ir
March t, current year March 1, wrrent year
If no, what is his / her exad share of interest?
If name on record is different than that
ot mortgagee or conVact
b=1ow:
Record number '' �. . -'
r�Cb �7
Page number
3335
as of Is the applicant the sole legal or equitable
ownef? ❑ Yes ❑ No
/
Ii owned with someone other lhan spouse, indicate with whom.
Address of mortgagee or wnVad selier (number and streef, city, state, ZIP
assignee or olher owner or holder of mortgage
Address of assignee (numberand s(reet, city, state, ZlPcode)
Does applicant own property in any other If yes, what county?
county in Indiana?
Deduction appro� ed in the amounf of:
20 O L
Signature
� � �
Is the property in question:
❑ Real Property ❑ Mobile Home pC &1.
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What G"G`^'�y,M.,
1
Ir'�r-'-.
COUNTY AUDITOR
20 � 20 20
/
County Auditor
20
Dale
20
requested on
' C� Yes � No
We certiy under lhe penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07 .
Address of aulhorized person
,