HomeMy WebLinkAboutMortgage_Rawlinson (2)°•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_� FOR DEDUCTION FROM ASSESSED VALUATION �
�- Slate Farm 43709 (R8! 2-07) i
�O ;��� 1 presoibed by Departmenl of Local Govemmmt Finance
�NSrRUCnoNS: �J�L^^�(I`7 2008
To be filed in person or by mad wAh the County Auditor o/ the county where Bre pmperfy is located. .
Fding Dates: 7) Real Pmperty: Dunng the 12 months befae June 17 of fhe year the deduc6on is to be eflecWe. `� ��
2J Mobde Homes assessed under IC 6-1.1-7: Behveen January 75 and March 2 of the year the deduc6on is fo be eff�'cliG��
See reverse side foradditional insbuctions and qualilcations. GIBSON COUNTY AUDITOR
icant w er or mn act 6uy8r - se stric �6IIS m re
� //
Ta - Dis 'G Key number I legal
nsses�a �� or rea� nw�r az� r.�ara, i, w�n y�r
I�hal is h¢ / her erzaU share of irrteresl?
If name on record is dAierent ihan ihat o/ applirant, indica
Name of nwrlgagee or canLact seller
Address of moAgagee or mnUad seller (numbes �
%
Name of assignee or olher owrier or holder of mortgage
Address of assgnee (numbeiaM strcet, city, state. aM:
Does applicanl own poperty in any other
counry in Indiana?
❑ Yes ❑ No
Deduclion appmved in Ihe amwnl of:
�� �_
Synature af Counry Audilar
sioe)
0
a
nw-�.>. 7�/- o a v� � o v
ge / Contrad indebledrress unpaitl as of March 1, Is Ih pGcanl �he sde legal w equiiade owner
�� �� 4l�
es No
If owned wilh someme dher Ihan spouse. i�rate with whom.
arrd
If yes, what counry?
Is �he WWeM in 9uestion:
❑ Real Property ❑ Mobile Home QC 61.1-7)
ao�7_�y�o
� � (w�
� : _ /
COUNTY AUDITOR
20 20 20
Counry
:equested an property
❑Yes ❑ No
20 20
Date (month, tlay, yea�
I/ We certify under the penairy of perjury ihat Uie above and foregoing info�rnatio� is true and correct and tha[ ihe applicanLS was / were a residenl of
Indiana and owner of the aforementioned property on March 7, 20 _
SigraWre(/o/y!ne/s(Wlname).�/��/
C: QA�in � �+ /irii.s�a2�
��dent address of applicant (num6er andsGeet cdy, slafe, and ZIP mde)
i�0o o3euu�/awF'ie/d Q,�uE �.PiN"�E�
Person auUwrizetl by duly executed Power of Attomey w by IC G7.1-72-.07
Address of aut7or¢ed persan (number arM stree4 �Y. state, aiW ZIP mde)
�
Y��
Date (mm&. day, yeap