HomeMy WebLinkAboutMortgage_Whitehead (5).a "^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION ��
State Fortn 43709 (R8l 2-07)
:� ' 1
ra�. R'asmbed bY DePertmenl of Local Govemmenl Finance
iNSrnucnoNS: JUL � �11eLUUU�
To be filed in person or by mad with Me CountyAuditor o7 the county whe2 the pioperfy is located. .
Fding Dafes: i) Real Proper(y.� Dunng the 72 months befwe June 17 0/ the year fhe deduction is to be eRective.
2) Mobile Hames assessed under IC 6-7.1-7: BeAreen January 75 and March 2 0( fhe year the deducUon:rs to�����
Sce reverse side )or additional insWctions aId qualifications.
GIBSON COUNTY AUDITOR
qppicant
see
�" Key number I legal desaiption
a�- a- - �a-a
popaty as af Mart�h 7. artmt y�r MMgage / Cantract
airtent year �--��
Is his � ner eraa snare
recortl
morigagee or oonLacl seller
Addr�ss of mortgagee or mntrad seller
Name ot ass9nee a olher o.vner ar holder
Address of asvgnae
Dces applicanl own property in arry dher
caunfy in IMiarro7
❑Yes ❑ No
Deduction appmved in Ure amwnl
0
Sig�aW ra of Counry Audilor
�
iMipte below:
as of March
Is the appGCant Ihe sole legal w
If awned w�h someone oiher Ihan spouse,
ZIP code) ���
Ifyes,whatcounry? W
COUNTY AUDITOR
2p 20 _ 20 _
Counry
number
❑ No
PrWeM in question:
2t Prpperty ❑ Mobile Hwrie QC 61.
m�,�s���
0�'� �5�
20
yea�
�
� No
i3i�
I/ We certify under the penalty of perjury that the abwe and foregoing infortnatio� is true and mrrect and ihat the appG�anis was I were a resident of
Indiana and owner of the aforemenfioned property on March 1, 20
�reture (owne(s hdi name) , . �- A . Date (month, day, yeai)
. address of applica1nt (n,u,mber an�Jd s4eet. af , stafe. aM ZI.P.[m
I E� i.(�O 77K S%_ ��� N C2. / 7f
m¢ed by dury esewted Power of Attomey a by IC Gt.i-12-.07
(number arM stree4 ah'. state, aiW
�
Dale (monfh, day, yea^