HomeMy WebLinkAboutMortgage_Jines (8)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
� �� J State Form 43709 (R5/4-03) .
�� Prescribed by DepaRment of Laal Govemmem Finance .
INSTRUCTIONS: i e Mark
To be filed in person or by mail with the County Auditor of the county where the property is located. APR 1 3���5 �
Filing Dates: 1) Real Property: Dunng the 12 months before May 11 of the year the deduction is to be eflective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 0/ the ye�pffje d��n is to be eNective.
See reverse side !or additional instructions and qualifications.
GIBSON COUNTY AUDITOR
or contracf buyer - s�restac3i/
� � Record number
�•j-� Q , � � 3,� Page number
�{J• �
Assessed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curcent year March 1, current year owneR ❑ Yes ❑ No
�
If no, what is his / her exact share of interest? If owned wilh someone other than spouse, indicate with whom.
If name on record is diHerent than that ot applicant, indicate below: Is the property in question:
��� � of mortgagee or contraIX seller
�
Address of mortgagee or contrad seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county?
county in Indiana?
Deduction approved in lhe amount of:
20 20
1
Signature
What Taxing District?
COUNTY AUDITOR
20�_ 20� 20
Y �
County Auditor
❑ Real Property ❑ Mobile Hmie pC 67.1-�
Has this deduction been requested on
property for current year? � Yes ❑ No
20
Date
20
�.Ve certify under the penalty of perjury lhaf the above and foregoing information is true and corred and that the applicants was / were
sident of Indiana and owner of the aforementioned property on March 1, 20
full name)
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
s�enc�aq�es�r a� nV �� �/��� � n IAddress of authorized person
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