HomeMy WebLinkAboutMortgage_Sander� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�+ ! Sute Form 43709 (RS / 4-03) �
� �«.
PrescADetl b�j Depaf,ment cf Lonl Gtivemment Finance ,�.�
INSTRUCTIONS: File Mark
To be filed in person or by mail with the Counry Auditor of the county where the property is located. � U� 2% Z��6
Filing Dates: 1) Real Property: Dunng the 12 months before May 11 of the year the deduction is to be ef/ective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the,year the deduction is to be eNective.
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See reverse side lor additional instructions and qualifications.
GIBSON COUNfiV AUBIi§�
Applicant (owner or con ct buyer - see restrictions on revers�de)
Taxing Dislrid ' Key number / legal descriplion f
(o-�a-o6-ao3-a,�F,��t/-o �s
�� � �r - b�l�a �� � `
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of
March 1, current year March 1, current year
If �io, what is his / her exad share of interest?
If name on record is different Ihan that of appl
'�me of mortgagee or conhad seller o
Address ol mortgagee or contract seller (num
number
number
�
Is the applicaM the sole legal or equitable
owneR ❑ Yes ❑ No
�O�(/UV �-�-'1�� I
rif owned with someone other than spouse, indicate with whom.
indicate below:
stree( city, state, ZIP
assignee or other owner or holder ot mortgage
Address of assignee (number and street: r.ity, srate. ZIP code)
Does appliwnt own property in any othPr � I! �••,; . 4,�ha[ cnunty? �Vhat Taxing District?
county in Indiana? I
COUNTY Al1DI70R
Deducfion appro��ed in ihe ama�nt of:
20 �1
P
Signature
Zn -�-$—
-�
20 _Q Y 20 � 20
P- -_�
County Auditor
❑ Real Property ❑ Mobile Hmie pC 61.1-�
_'�
Has this deduclion been requested on
property for wrrent yea(? � Yes ❑ No
20
20
yr(der ihe penalty of per,u�� rha� the above and forr.aoina info.�nat�on is !me and correct and ihat the applicants was / were
Indfan� ?nd owner of th? aforemenfioned property on March 1, 20 __
Person a��thorizeA by duly executed Power of Httorney
or by IG 6-1.1-12-.07
aoolicant n n � �Address of authorized person