HomeMy WebLinkAboutMortgage_Kramer (15)�.� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
� � ! Siate Fortr: a3709 (R5 / 4-03)
�« �Piesrribed by Departmem of Local Govemmen� Finance
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INSTRUCTIONS: y� �
To be filed in person or by mail with the County Auditor of the county where the property is located. s E P 1 9����
Filing Dates: f) Real Property: �During the 12 months before May 11 0/ the year the deduction is to be eBective.
2J Mobile Homes assessed under IC 6-7J-7: Between January 15 and March 2 0! the yeaythe dedvcty�� is to be eNective.
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See�reverse side (or additional instructions and qualifications.
� � � GIBSON COUNTY AI�DiTOF
Taxing
buyer
��,,
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share
Key number / Iegai description � Record
� /�-o�3a
Mortgage / ContraU ir
March 1, current year
If name on record is different than thaf of applicant,
mortgagee or conlrad seller
[�J
Page number
unpaid as of Is the appliwnt the soTlegal or
owner? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
Address of mortgagee or contraIX seiler (number and street, city, sfate, ZIP
Name of assignee or other owner or holder oi mortgage
Address of assignee (numberand street, citv. stata ��o ��a�)
Does appl
county in I
Deduction :
20
I
Signature _
Is the property in question:
❑ Real Property ❑ Mobile Hmie (IC 61.
� What Taxing Districl? Has this deduction been requested on
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D ra�v e r N O. �. ••••••;•� •� property for current year? �] Yes � No
� �� �
CardNO: � .................... iUNTYAUDITOR
+����' � �
� I �
20 20
County Auditor
20
Date
20
We certify under the penalry of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20 •
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Full resid�nt address of applicanf � � Address of authorized person