HomeMy WebLinkAboutMortgage_Stewartrt�° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
`� � J SUte Fortn 43709 (R4 / 10-07) !�
a� �'i d /�
� Prescribed by Department of Local Go�emment Finance /
INSTRUCTIONS: �A���g �W'a2003
To be filed in person or by mail wifh the County Audrtor o/ the county where the property is located.
Filing Dates: 1) Real Property: During the 12 months be%�e May 11 of the year the deduction is to be ective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 0/ the e d���'�s t�nHec ' e.
See reverse side (or additional instNCtions and qualifications. ' GIBSON COUtii� qu0�70�
on r�4er�e side)
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Taxing Districl // wnber-He ' tion rtmnbe�-
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��_ L_, ` �J/�— � / n � o O Page number / O 3 / �
T�ri�� �y y
Assessed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equitable
March 1, curtent year M , rrent year � 0 ownef? ❑ Yes ❑ No
��V � f
If no, what is his / her exad share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of apptiwni, indicale betow: Is the property in question:
of mortgagee or
�% 3
o( mortgagee or contrad selier (number and street, ciry, state, ZIP
Name of assignee or olher owner or holder of mortgage
Address of assignee (number and sheet, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing District?
county in Indiana?
Deduction approved in the amounl of:
20 20 Q
�A.t.t/ " 1
Signature
COUNTY AUDITOR
20 �_ 20 /7 7 20
�
County Auditor
❑ Real Properiy ❑ Mobile Horrie QC Fr1.1-�
Has this deduc[ion been requested on
property for cunent yeaR � Yes � No
20 � I 20
Date
certify under the penalty of perjury thal the above and foregoing infortnation is irue and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ofauthorized person