HomeMy WebLinkAboutMortgage_Richardson (2)�Ay STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� ' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
J Sfate Fortn 43709 (R6 / 5-06)
� Prescnbed by Depanment of Loral Gwemment Fnance
1
INSTRUCTIONS: MAY �F��
To be filed in person or by mail w8h the County Auditor of the county where the property is located.
Filing Dates: 1) Real Properiy: Dunng the 12 months before June I1 0! the year the deduction is to be eflective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year %e�luc i`o�to be effective.
See reverse side for additional instructions and qual�cations. GIBSON COUNTY AUDITOR
(owner
Taxing District
see
number / legal description
number
age number
/l,v��.c.e.�� a 6- b2 0 7-� 03 -003. � ��s
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, curtent year owner? � Yes � No
a� �o a
no,
name on
or
Address of mortgagee or contract seller (number and street, city,
or other owner ar
mortgage
Does applipnt own property in any ottier If yes, what county?
county in Indiana?
S
i�n appr�o� L: ����RC �
��`' V..�
'� 5
c��' aa`�
someone other than spouse,
ZIP
What Taxing District?
COUNTY AUDITOR
20
...uunty Auditor
�
❑ Real
0 Mobile Home QC 61.1-�
Has this deduction been requested on
property for wrrent year? ❑ YesO No
2�
Date
�
We certiTy under the penalty of perjury that the above and Toregoing information is true and correct and that the applicants was / were
4sident of Indiana and owner of the aforementioned property on March 1, 20
or by IC 6-1.1-12-.07
ress ot applicant Address of authorizetl person
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