HomeMy WebLinkAboutMortgage_Miskell� STATEMENT OF MORTGAGE OR CONTRACT INDI
FOR DEDUCTION FROM ASSESSED VALUATION
... State Form 43709 (R8l 2-07)
�' a„ � Presmbed by Departmenl of Local Govemmenl Finance
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To be filed in person or 6y mad wrth the CounfyAuditor of the courrty where fhe p/operty is located.
Fd�g Dafes: i) Real Pioper(y: During the 72 months be/ore June 77 W fhe year fhe deduc6on is to be eReclive. // ,Q
2) Mobile Hortres assessed under fC 6-1.7-7: Befween January 15 end March 2 of the year fhe deduction is to be eNaef�. ve. �
SeereversesideforadditionalinsLuctionsandqualifications. GIBSON COUNTY AUDITOR
I ��
�m
1 If reme
�/— ' iA % .:J ' 1
of real popary as d March i. anenl ye�ar Abrtpaga / ConVaa
airtent year ,
is nis / her exect share m i
record is d'AtereN Uw� Iha
«�� o�� ��
mongagee or owmaa sd�
� Nartre of azsgnee or oltrer ownar
I OeduOion
�
� Sgreture
own proparty in arry olher
m?
❑Yes ❑ No
�
ican4 irdi�-ate belav:
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oe, a�e s�c �r. sra�e. �a
m�9a9e
9ate, aM ZIP mde)
If yes. what counry
%Of 7 '- VOS
unpai0 as of March 1,
Page
appGranl lhe sole legal w equitahle wmeR
❑Yes ❑No
If owned wilh mmeone dher Ihan spouse, indifate with rfiom. _-
COUNTYAUDROR
2p _ 20 _ 20
Caunry
Is Ne praperN �� �� f' �� O.�/,�
r' �(nJ V '
��a"er NO
K~
r
Card. � 7'YI �O o �
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Has Uus deduciian been requestad an poper�y
fw aurent yeaR
❑ Yes ❑ No
20 � 20 _
tlay, yea�
i/ We certify under the penalty of perjury that the above and (oregoing intwma6on is true and coRect and Ihal tlie appiicants was / were a residenl o(
Indiana and owner of tlie aforemen6o�ed property on March 1, 20
�n�re(owneYSlullnama)� .n _ � . . Dateimonlh.day,Yean _
s8eet dfy. ;fafe, arM ZIP ootle)
ezewled Power of Pl�orney ar by IC
aulhwaed person
Date (rtmfh. daY. Y�A