HomeMy WebLinkAboutMortgage_Roberson� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
� µ� / Siate Fartn 43709 (R5 / 4-03)
� P'esaiDed �y DepartmeM of Laal Govamment Finance
INSTRUCTfONS: �
To be filed in person or 6y mail with the County Auditor of the county where the property is located._
Filin Dates: 1 Real Pro e Durin the 12 months before Ma 11 0l the �fb� ��r��U � r-
9 ) P rtY� 9 y year the deduction is e
2) Mobile Homes assessed under IC 6-1.1-7: 8ehveen January 15 and March 2 0/ (he year the deduction is to be eflective.
See reverse side tor addilional instnrcfions and qualificafions. �7j� ,e�
GIBSON COUNTY AUDITOR
Applicant
District
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��W "�-1-%� 1'�-' . — ia- d$-a03 0�.1 _ 9e number 5 75�
Assessed value of real property as of Mortgage / ConVad indebtedness unpaid as o Is the applicant the sole legal or equitable
March 1, current year March 1 rrent year ��I O OD owneR ❑ Yes ❑ No
�OOO�
If no, what is his / her exaa share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is drfierent ihan that of appGcaM, indicate below: Is the property in ques6on:
■•�.• ■ - -
of mor�qagee or contract seller
�
Address of mor�qagee w contrad selier (number and sheef, aty, state, ZIP
Name of assignee w other owner w holder of mortgage
Address of assi�ee (number and sheeR ci1y, state, LP
Does app6cant awn prope�ty � arry Wher I If yes. what county? �M�at Taxmg District? Has th's dedudion been requested on
munty in Ir�ana?
property for aureM yeaf) 0 Yes ❑ No
Demrction approved
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COUNTY AUDffOR
in ihe amount of.
2A �_ 20 O� Zp _
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,Ve �tii,, ,ader the penafl„ of perpu„ tlmi U�e above ard (ar�g udm,atia, is true ard oarted ard tl�a, 9�e app6�,vas,,aere
esde�d of �a �d awner d the aWremaGiored propgty on Mard� 1. 20
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Pasoa� aWhataed by thd�r o�ea6ed Pomer of Atlurney
or by IC 61.1-12-.07
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