HomeMy WebLinkAboutMortgage_Gaston (6)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION C T,-Town1]s�hip Year
S �a. ! State Fwm 43709 (RS / 4-03) ( q � . �
� Prescn0ed �y Department o( Loral Govemment Finance
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INSTRUCTIONS: F�le Mark
To be frled in person or by mail with the County Auditor of the county where the propeRy is located. •_� �/I
Filing Dates: 1J Real Properry. Dunng fhe 12 months before May 11 01 the year fhe deduction is to e e �� "v?`�'
" L,�JiJ.y rC;��\�,y _'.r�!TM
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Maich 2 0/ the year �lie deduction is to be eflective.
See reverse side for additional instructions and qualiTcations.
Taxing Distrid '
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Assessed value of real property as of
March 1, wrrent year
no, what is hi;.l,her exad share of
side)
Key number / legal description
oi9- oo9i�- �
number
number
MoAgage / Contrad indebtedness unpaid as of Is lhe applicant the sole legal or equilable
March 1, current year owneR ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
If name on record is different than tKat of applicant, indicate below:
�ame ot moRgagee or contred seller _
� Ald.! U
Address of mortgagee or contrad seller (number and street, ciry, state, ZIP
Name of assignee or other owner or holder of mortgage
Addre. '—'—�-���-�rate..ZIP code)
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6 y _39G�
Does ��� / mty? What Taxing DislriIX?
couni G�""" __ {,�' �/�I—f���
(p�a�+� Uti
sy ° °j �. COUNTY AUDITOR
Deduction approved in the amounl of:
20 d•� 20 20�
P
Signature
� � i
County Auditor
20 �
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❑ Real PropeAy ❑ Mobile Home (IC 61.1-�
Has this deduction been requested on
property for curtent yeaR� Yes� No
20
20
We certify under lhe penalty of perjury that the above and foregoing information is true and corred and that the applirants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
�
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
authorized person