HomeMy WebLinkAboutMortgage_Howell (4)���.
�ea ' Ay STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
, �j State Fwm 43709 (R6 / 5-06) -
.� Presoibed by Department of Local Gwemment Finance
Count Township Year
E, i
lNSTRUCTIONS: AU���S �y�o)
To be filed in person o� by mail with the County Auditor of the county where the prope�ty is located. �
Fi/ing Dates: 1) Real Property: Dunng the 12 months befoie June Il of the yea� the deduction is to be ef/ecti
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o/the year the �dre�,iQ� elfective.
O
See reverse side for additional instructions and qualifications. GIBSON COUMTY AUDITOR
(owner or contract
Taxing
� ,� a�-Ia-����
�sessed value of real property as of
March 1, currenf year
If no, whal is his / her exad
uons on reverse sf e)
Key number'/ legal description
1D(-L�•5�a-D
MoAgage / Contred indebtedne
March 1, current year
name on record is different Ihan that of applicant,
of moRgagee or conVact seller
Address of mortgagee or conVad seller (number and
Name of
Address
or other owner or holder of mortgage
below:
(number and street, city, state, ZIP code)
Record number
�� Page number
unpaid as of
Is the applicant ihe sole legal or
ownef? ❑ Yes' 0 No
If owned with someone other than spouse, indicate with whom.
Is lhe properfy in question:
❑ Real Prope�ty ❑ Mobile Home
. � ,. ,i _. ,. ..
ZIP
Dues applipnt own property in any ///���
county in Indiana? // � _ .� / _ �
Y l [t.�,t�,0�ih
b�-334? ��'�`'t'�
Dedudion approved in the amoun, ,,,.
20 � SZ 20
1
Signature
20 20 20
County Auditor
itflCt?
Has this deduction been requested on
property for current yeaR � Yes ❑ No
20
Date
20
certify under the penalty of peryury that the above and foregoing information is true and correct and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
ire (o n s full e) Person authonzed by duly executed Power of Attomey
� � or by IC 6-1.1-12-.07
authorized person