HomeMy WebLinkAboutMortgage_SatterfieldSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
• FOR DEDUCTION FROM ASSESSED VALUATION
�'• ! State Form 43709 (RS / 4-03) .
� PresaiDed by Department ot Local Govemment Finance
INSTRUCTIONS: � � �
To be filed in person or 6y mail with the County Auditor o( the county where the property is located. A PR 1� ZQ06
Filing Dates: 1J Real Property: Dunng the 12 months be7ore May 11 of the year the deduction is to be eBective.
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year tt�_��a duction is to be effective.
See reverse side for additional instnictions and qualifications.
4 � ,�
GIBSON COUN7Y qUpl70q
�
Applicanl
on reverse
i axing uistnq - Key number / legal description � Record number ��
� ' �' J'(�� / % ���-�j/� Page number ���
( l V / �C./
Assessed vatue of real property as of MoAgage / ContreU indebtedness unpaid as of Is the applicant the sole legal or equitable
March t, current year. March 1, currenl year owner? ❑ Yes ❑ No
l ��(/� ' _ "
If no, what is his / her exact share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different lhan ihat of applicant, indicate below: Is the property in question:
mortgagee or contrad selier
Address of mortgagee or wntrad seller (number and street,
Name of assignee or other owner or holder of mortgage
of assignee (number and street, city, state, ZIP
Does appiicant own property in any other If yes, what county?
county in Indiana?
approved in the amount of:
20 �
Signature
ZIP
What Taxing District?
COUNTY AUDITOR
20��_ I 20 0� 20 I 20
� �
County Auditor
❑ Real Properry p Mobile H«ne (IC 67.1-n
Has this deduction been requested on
property for wrrent year? Q Yes � No
20
Date
20
We certify under the penafty of perjury that ihe above and foregoing information is true and correct and that lhe applicanls was / were
�esident of Indiana and owner of the aforementioned property on March 1, 20
full
of
Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
Address of authorized person