HomeMy WebLinkAboutMortgage_Pinson.��"r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co �'iowt� Year
,,. FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (RB! 2-07)
•°�; •� Presaibed by Departmenl of Local Govemment Finance
•N C il a
INSTRUCTIONS:
To be filed in person or by mail wifh the CountyAudifor ol the county where fhe pioperty is lorafed. �
Fding Dates: 1J Real PropeAy: Dudng the tt months before June 17 o(the yeerthe deduc6on is fo be e/fec6ve. �lG� �%a�-�
2) Mobile Homes assessed under IC 6-1 J-7: Between January 15 end March 2 0/ the year the deduc6on is to be eA9C6ve. �
See2versesidelwadditionalinstructionsandqualifiwtions. GIBSON COUP!TY AUDITOR
buyei - see rey�i¢ions m reverse sde)
_ _
6 - .07 -. o -o�a. /! -ba-
setl value of real propaty as of March 7, current yeer Mortgage I ConVad indebledness unpaid as M March t, Is the a
airtentyear
�/ O d
whal is his / het ezaG share ot iMeres�? If wmed with someone ather than spouse,
Ii name on record is d'rfFerent Nan ihat oF applicanl, iMiqte below:
Name of rtwrtgagee ar conVact seller
L.(-/-v`.--/���'��/}�'�
Addr�ss of moM1gagee ar mnlra�l seller (num6ei aiM stieet aty. stafe.
Name of assignee w other o«ner ar hdtler of mwtgaga
Address of assignee (n�mbar end s4eet, city, sfate. end ZIP oode)
Dces applicanl own property in eny dher If yes, whet m
counry in Indiana?
� Yes ❑ No
Deduction approved in ihe amount of:
`4��
SignaW re ot Counry AudMr
20 � 2b
d nubmber Paga number
�O 57��
u,e sae �egs� «equivae wmen
❑Yes ❑ No
� wiN wtam. '
Is the propeM1y in quesGOn:
❑ Real Properly ❑ Mobile Home
_ �,so�, ���«y
�: �8- ����
20 I 20
20
Date (monfh. day. yee�
v�m
❑ No
20 _
I! We certify under the penalry of perjury that the above and foregoing infwmaGOn is We and correct and fhat Ihe applicants was / were e residenl of
Indiana and owner ot Ne aforementioned property on March 7. 20
iwwre fowners fiAMamel ' Oate (monlh, Eay, yea�
Person
sfreet. city. sfate. aM
�jtan w by ��.t
of aullcraed persm (number aM sheel. rAy. state, aM
0