HomeMy WebLinkAboutMortgage_Ward.• °'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_= FOR DEDUCTION FROM ASSESSED VALUATION �
. ' � S1ale Form 43709 (RB / 2-07)
S,�,� 1 Rasmbea by Departmenl o( Local Govemment Finance Y R D A ON
u �ec o' �le M rk
iNSrnucnoNS: _ d�,� �_ —
To be filed in person or by mad with the CountyAuditor o7 tAe county where the properfy is located.
Flmg Dates: 1) Real Property: Dunng the 72 monU�s 6e/ore June 71 0/ the year the deduc6on is to be eflec6ve.
2) Mo6iie Homes assessed under IC 61.1-7: Behveen January 15 and March 2 of the year the dedu Auditor
See 2verse side /a addfanal insbUC(ions arrd qualificafions. $Z%� Gibson CW n[y
Applicant(ownercrw 6uyer-seere mreverse ' . ' "•"•
T Dislricl ey n / I desaiption Reoor� um Page rwmber
- - � �o -003.0 ���a8 � o
qss�ed rWue o( real popaty as oF MaN� 1. arreN year Mwtgage / CwiUad rtidebledness wpaiC as of March 1. Is 1he app6ranl Ihe sde legal u eq�dtade ovme(t
artent
q, - ❑Yes ❑No
i��vhat is his / her ezad share of interast? If owned wilh someone ather Ihan spouse, i�cale with whom.
If riame on record is tlH(eren� �han Utat
Name of rt�ortgagee ar cmlraG
mo�igagce u cmlraG seller (number and 9ieeC ary,
atfrer onner or holder of mortga9e
Address of assi9riee (rnanbu aM s4eeC
applicaM own property in arry olher
y in lixlana?
❑Yes �No
Deduction appmved in Ihe amwn� of:
Q�Z�'�
aib
�.�m�.-• � �//1-/ r-
��'�"'/.�/ 7�g0
/ / /� �
��S� �. � y c o-►�
2p 20 20
Counry
Is Ihe property in question:
❑ Real Pmperty ❑ Mabile Hane
Has Ihs ded Wion been requesleC on property
r« wR�„� Y�n
❑Yes � No
20
20
I/ We certify under the penalty of perjury that fhe above and foregoing infomiaGon is We and corted and thal the applicanLS was / were a resident of
Indiana and owner of ihe afwementioned property on March 1, 20 "
� ent address o applKaM (numbei and
n aWMr¢ed by Auly exewted Power /
Address of aNhor¢ed person (numberaM sb
crty, state, antl
IC
pty, slate, arM ZIP wde)
Date (nronN, Oay,
Dale (mmth, day, yea�
1