HomeMy WebLinkAboutMortgage_Kantner�� "'� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION
C �. / S1eteFwm43709 (R615-O6)
«•
� Prasaibed by Depariment ot Local Gwemment Finance
INSTRUCTIONS:
To be frled in person or by mail with the CountyAuditor of the county where the property is located. p �
Filing Dafes: 1) Real PropeRy: Dunng the 12 months before ,lune 11 of the yea� the deduction is to 6e e'HectDe.l 00 �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 of the y�ea-yr �t,he deduction is to be effective.
See reverse side for additiona/ insWctions and qualifications. l/'�6� ��
GIBSON COUNTY AU�ItOS�
7axing Distg�t /
�i
����
Assessed value of real property as of
March 1, current year
�t no, what is his I her exact share ot
If name on record is different than th
^'���ne oi mortgagee or contrect selle
Address of mortgagee or contract se
Name of assignee or other owner or
J
m
��umber / Iegal�descripUon
/�- D % �O/- 9CJ//�/-
Mortgage / Contrad indebiedness unpaid as of
March 1, curtent year
(Do� %U� ��6� /
If owned with someone ot
of applicant, indicate below:
/0� c� ���
�r (number and street, city, state, .
(numbe� and sbeet, city,
xd number � h
I /
: number � � ��
Is the applicant the sole�legal or
i
owner? � Yes -A}o.
than spouse, indicate witti whort
s the pr
❑ Real
s-i-oa---
���.���� �
Does applicant own property in any ofher� If y�,. �����2J �, ; Has this deduction been requested on
county in Indiana? . I �,� � rn '.7� property tor wrrent year? ❑ Yes❑ No
� �SD. 4z
in question:
� Mabile Home QC 61.1-
20 O �
Signature
amount
� I�)�
•
COUNTY AUDtTOR
20 4 20 20
/
County Auditor
20
Date
20
I/ We certify under the penalty of perjury that the above and foregoing infortnation is W e and correct and that the applicants was / were
�=sident of Indiana and owner of the aforementioned propeRy on March t, 20
�gnatu (owners full
�/ � .
r
Full re ident address c
�( �D l,c� . I
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
>s of authorized person