HomeMy WebLinkAboutMortgage_Morrison (11)�
f
� .__ ♦
u�•
�
STATEMENT OF MORTGAGE OR CONTRACT INOEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
Sute Fwm 43709 (RS / 4-03)
Prest+ibed by Department ol Loral Govemment Finance
Coun Township Year
J � f� � i! \i
INSTRUCTIONS: � � �J ��
File Mark
To 6e filed in person or 6y mail with the County Auditor ol the county whe�e the property is located. � � T � s Z��6
Filing Dates: 1) Real Property: During the 12 months be%re May 11 0/ the year the deduction is to be ef/ective.
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0l the year,the deduction is to be effective.
See reverse side !or additional insWctions and qualifications. �6� 'G �
GIBSON COUNTY AUDITOfi
Appiicant (owne�orcontracf buyer- see restrictions on reve�se side)
Districl
number / legal description � Record
a�-ra-o�-a.��-ooa.o����8
�`� + . P � ��' l _ O �� � _Q Page number
� � ,� . •
Assessed value of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applicant he sole legal or equitable
March i, current year March 1, wrrent year owneR �s ❑ No
I
If no, what is his / her exaa share of interest? If� ed with someone other than spouse, indicate with whom.
If name on rewrd is different lhan thal of applicant, indicate below:
of mortgagee or contraIX selier
oi
Name of assignee or
or contract seller (number and street, city,
owner or holder of mortgage
Address of assignee (numberand sfreet, city, state, ZIP code)
I�lhe property in question:
L_�al Property p Mobile Home (IC fr1.1
� - �. �.J,
m
�
Does applicant own property in any other If yes, what county? What Taxing Distnct?� �"--�'"� � �sted on
county in Indiana? --� n1�(L�50l-� 'es� No
-�aN� �
COUNTY AUDIT( 1 ��
Deduction approved in the amounf of: O I„ �� —
\lJ
��_�
Signature
3���ii"�m
�
County Auditor
Date
zo
certify under the penalty ot peryury that ihe above and foregoing information is true and correcl and lhat the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power
or by IC 6-1.1-12-.07
Full tesident address of applicant � Address of authorized person