HomeMy WebLinkAboutMortgage_Dogloso Properties LLC�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
: w� J State Fwm 43709 (RS / 4-03)
� PrescnDetl by Department of Local Govemment Finance
INSTRUCTIONS: �Fil M�rk�
To be filed in person or by mail with the County Auditor of the county where the propeRy is located
Filing Dates: 1J Real Property: During 1he 12 months before May 11 oJthe year the deduction is to be effective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Maich 2 of the year f�eAd�dy�ctjpn is to be eNective.
See reverse side for additional instructions and qualifications. � y 2007
Applicant (owne�
Taxing Distnrid
'Y W " �
see
Assessed value of real property as of
March 1, current year
�
GIBSON Ci
Key number / legal description U Record number
�.(p -�ot'07'30d-00.j-040-Od8 a O�
�I �,% _ Q �O �O �A Page number � � �
� ( VV
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year owneR ❑ Yes ❑ No
If no, what is his / her exact share of interest? It owned with someone other than spouse, indicate with whom.
If name on record is difierent than ihat of appliwnl, indicate below: Is the property in question:
❑ Real Pmperty ❑ Mobile Hane (IC 61.1-�
,me of mortgagee r contract seller /-�Q ����
ii
Address of mortgagee or contrad seller ( - , Z�p
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand street, city, state, ZIP code)
Does applicant own property in any other If yes, what county?
county in Indiana?
Dedudion approved
20
Signature
� l y'�
in the amount of:
20 �_ 20
1
What Taxing District? Has this dedudion been requested on
propeAy for current yea(? � Yes ❑ No
COUNTY AUDITOR
20
Counry Auditor
20
20
Date
20
certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
name)
1 Full resident address of applicant
� lll � 3��nDUm./ �e���c.�o� /nl 4767
Person authorized by duiy executed Power of Attorney
or by IC 6-1.1-12-.07
of authorized person