HomeMy WebLinkAboutMortgage_Wilson (5) alSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township l Year
FOR DEDUCTION FROM ASSESSED VALUATION �PIE'YIpj4
State Forth 43709(R11/609) • 1
•Presaibed by Department of Lod Government Finance / f�f
File Mark
INSTRUCTIONS: _ ; me(t , [ .
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. r 15
Filing Dates: 1) Real Properly:Must file during the year for which the deduction is sought • County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months .
before March 31 of each year the d . n is sought _ Gies.. .' ,,1%Nji: .,l et
See reverse side for additional instructions and quart •' ns. .( '/� /l 4 • ' . AUDI T[1R
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T-: . • / Key 1 desaigtion Record Page number
.r /4 /%ia-// -ooO. 9 da? o_ 353
• - = value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the app kart the sole
March 1:c rrent year March 1,current year data of a .�/°n legal or equitable owner?
d ❑ Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is 6frerent than that of applicant indicate below. Is the property hi question:Annually Assessed
VReal Property ❑Annually Assessed
• �C Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller '
Address of mortgagee or contract seller(n a S city,sbte,and ZIP code)
Name of assignee or other owner or holder of lie //1
•
Address of assignee(number and.r-ae4 city,state,and ZIP code)
4-240,42.--iyaey `��j�`-/Doe s applicant own property in any other If yes,what county? • What 'atdcl? as Nis deduction been uested on property
county in Irdara? ❑ No r current year? ❑ Yes ❑ No
❑ Yes
COUNTY AUDITOR
Deduction approved in the amount of.
20 20 20 20 20 20 20
Signature of County Auditor ' County Data(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owners full name) Date(month,day,year)
- .. r2€L 7
Full resident address f applicant(number all stiee city state,and ZIP code)
X / s7 r..4 t- ggq I.
P f authorped by d t of
Attorney or by IC 61.1-12-0.7 Data(month,day,year)
!'n 7 76.77'
Ad W rw'4 person n (number and street city state,and ZIP code)
.P °^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
2 FOR DEDUCTION FROM ASSESSED VALUATION
s�ie F«m a3�os (rxa r 2-0»
'� �sw 1 P2smbed by DepaM1menl of Local Govemment Finance
ile M
INSTRUCTIONS:
To 6e filed in person w by mad wdh the CountyAuditor o! the county where fhe property is bcated.
Fding Dates: i) Real Property: Dunng the 12 months before June 17 0/ the year the deduction is to be etfecfive. ,,A
2) Mobile Homes assessed under IC 6-7.1 J: Behvaen January 15 and March 2 0/ the year Me deducGon is tOmEi�fle�ti�. 2 � ��
See ieverse side )or addi6onal ins6ucGons arrcl qualifications.
6uYar - sge restri�ti°"s °^
Ta�drg Disiri�t
QI(o-I I I' 1 d'.
PSSessed Yalue of real P�P�Y a5 0( MarCh 1. aarent Y�r
If r^ what is his l lrer exacl share of inleresl7
�
If riame m record is difierenl Ihan �hal of appl
Name of mortgagee or
, C (�,Q�� GIBSON COUNTY AUDITOR
ppn Reoortl num r Page number�
- . �S- $ D � 3 3
gage / CpnVap udebtedness unpaid as of March 7, Is ihe app6nnt Ihe sde legal n equitaWe owneR
❑ Yes ❑ No
If owned wilh someone dher ihan spouu, indicate wifh rrhom.
Adtlress of morigagee u mnlrad seller (number aM slree(. dty. 9ate.
Name of assignee w olher oaner or holder of mortgage
qCdrrss otassgnee (mmberarM sVeet, dty. sfate. ar�d
Does applicanl am propeNy in any other
oounry in Indana7
❑Yes ❑No
DeduGion approved in �he amwn� of:
20 � 20
Sigrawre ot Caunry Autl4ur
/
LlYCOtle)
If yas, whal caunry?
1
couNTVn�
�
Zp- I °"�
I/ We cerfify under ihe penalty of perjury that the above and foregoing infortn
Indiana and owner of ihe aforementioned property o� March 7, 20
Signa (rnmersfi9lneme) -
tlent addr f applicant (number and sUeeL cdy. sfate. and ZIP code)
Pasvn aulhor¢ed by Auly execuled Power of Nlaney or by IC G7.1-12-.07
Addrrss of auUra¢ed persan (number aM sbeel, r4y. slate, aM LP mde)
Is �he property in quesUon:
❑ Real Pipperty ❑ Mobile Home QC G7.1
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Dale (rtronth, day, yea�
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