HomeMy WebLinkAboutMortgage_Shawhanjei �� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'` „ FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
' � . «� , y State Fwm 43709 (R6 / 5-06)
� I Presaibetl by Department ot Local Govemment Fir�arxe
INSTRUCTIONS �AN 1 F�Ie,MadC
To be filed in person or 6y mail wdh lhe CountyAuditor ol the county where the property is located. LUU l
Filing Dates: 1J Real P�operty: Dunng lhe 12 months befae June 11 of the year the deduction is to be effective.
2J Mobile Homes assessed under IC 6-1JJ: Between January 15 and March 2 of the yearY�Fe-�dgducNEion�s�to be effective.
See reverse side for additional instiuctions and qualfications � V
GIBSON COUNiY AUOi7pP
Appli t(ownerorcont t uyer-s
Taxing Distri
��
Assessed value of real property as of
March 1, curtent year
If no, what is his / her exact share
If name on record is different tha
me of mortgagee or contrad
on reverse side)
Key number / legal description Record number O/
a�o -/a-07-303 -4Dd. /65-0�8 �o
I � I) ��'^;� " Page number ^�O
1 �� C� /
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or e
Mar 1, current year ."� u p� ownef? ❑ Yes ❑ No
-- _.�_r_, c,� b >>
�� //� � ���� �� N .eone other than spouse, indicate with whom.
��-�,�50
`� JKi �V �Y
Address of mortgagee or contrad seller (number and street, i
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and stieet, city, state, ZIP code)
Does applipnt own property in any olher I If yes, what county?
counly in Indiana?
Deduction approved in the amount of:
20
�� 20�_
P -�
state, ZIP
VYhat Taxing District?
COUNTY AUDITOR
20 0 4 20 20
P
County Auditor
❑ Real PropE�rly ❑ Mobile Hortie QC 6-1.1
Has this dedudion been requesled on
property for curtent yeaR � Yes ❑ No
20
Date
20
ify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly execuled Power of Attomey
or by IC G1.1-12-.07
ofauthorized person