HomeMy WebLinkAboutMortgage_Gordon� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Year
,�..._ = FOR DEDUCTION FROM ASSESSED VALUATION
' S�ate Form 43709 (RS / 2-07)
`s•, .. ° Preso�betl by Department of Lofal Govamment Finance
AUG 2 ��� �
INSTRUCTIONS:
To be Rled in person o� by mar7 with the CountyAuditor d fhe county where !he piope/ty is located.
Fding Dates: 1) Real Property: Dunng the 72 monfhs be/de June 71 0! the year the deducfion is to be eflective. /1
2) Mobile Hames assessed under IC 6-1.7-7: Behveen January 75 and March 2 of the year fhe deduc6�� eA ti .
See reverse side tor addiFional instructions arM qualificafions. GIBSON COUNTY AUDITOR
' Key mimbnf / le( al destriptian
_i
propaly as o( March 1. arrent yESr Matgage /<
wrreril year
e:�aci share ot interesl?
f.fuenl ihan ihat of awlicant iMiple Delow:
Atltlress of rtangagee w
Name of asagnee a alher owrier or holder
licant own property in any olher
Indaria?
❑ Yes ❑ No
Deduction
� q '
amounl
20
. !O -V w U
indebtedness unpai0 as o March 1, Is Ihe applimnl iha sde legal a equitable owne(:
��� ❑Yes �No
If ownetl wuh sort�eme dl�er Ihan spouse, iMicate with whom. ,
i.waeL dry. state. an0 Lv croee)
age
aiM ZIP code)
If yes, what county7 What Taaing D�
�1��J � J COUNTYAUDITOR
20 _ 20 _ 20
County
in question:
�ty ❑ Mobile Home QC 61.1
Drawer NO..�..�'-•���!
/
CardNO . .....................
�
lJ Yes LJ No
20
I I We certify under the penalry of perjury that Ihe above anU foregoing infwmatio� is we and correcl and Ihat tt�e applicants was I were a resident of
Indiana and owner oi the aforemenGOned property on March 1, 20
��LUe (owneYS lu/l nartre) � �� �� 1 Dale (monfh, daY. Y��
X !•-\ R - � n _ c�R
and sfrcet cify, sfale. and ZIP code)
authorized by duly exeated Power of Altaney or by IC 61.
Adtlress of aWtrorized persa�
�ale (rtron(h, day, yea�