HomeMy WebLinkAboutMortgage_JP Patel Inc��� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
i' State Fortn 43709 (R6 / 5-06)
� Presrnbed by Deparimem of Lo�al Govemment Finance
INSTRUCTIONS: FE� F'i�M�,u,�s
To be filed in person o� by mail with the County Auditor of the county whe�e the propeRy is located. 1
Filing Dates: 7) Real P�operty: Dunng the 12 months 6e/oia ,lune 11 0/ the year the deduction is to be elfective. ��!��
2) Mobile Homes assessed under IC 6-1.1 J: Between January 15 and March 2 of the yea� the�ya&'yA�Ytey'8e effective.
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See reverse side for additional instructions and quali�cations. GIBSON COUNTY AUDITOR
(owner or contract 6uyer - see
Taxing Distrid
��
�d�2_�
Assessed value ofrealproperty as of
March 1, curtent year
I( no, what is his / her exad share of
If name on
o � verse �le)
�'�n c�
Key nutnber / legal description Record number
a�s
�6-/ a• ofr-�o l a.��. S36 age number
� L
Mortgage / Contrad indebtedness unpaid as of Is lhe applica t th ole legal or equitable
March 1, curtent year ownef? �s ❑ No
/ � Q�Q
If owned with someone other than spouse, indicate with whom.
than that of applicant, indicate below:
mortgagee or conVact seller
of mortgagee or contrad selier (number and street, aty, state, ZIP
of assignee or other owner or holder of mortgage
(number and street, city, state, ZIP code)
Does applicant own property in any other I If yes, what county?
county in Indiana?
Y�f s� � -a io
Deduction approved in the amount of:
20 �� 20 � 9 2p
i �
Signature
20
County Auditor
property in question:
al Property ❑ Mobile Home (IC 61.1-�
. i
What Ta � �ng. D���'� �"
� _ a0b5�����
pr:n�'�� �O"•.••' y .
AUDITO. ��•'.... ..
�.,� a � � ��5;�00
20 _ _ � 20
Date
20
��ested on
Yes ❑ No
certify under the penalty of perjury lhat the above and foregoing infortnation is true and corred and that ihe applicants was / were
lenl of Indiana and owner of the aforementioned property on March 1, 20
(owners full name)
address of applipni
a
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
authorized person