HomeMy WebLinkAboutMortgage_Youngjui '� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
��s•� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
j • State Fortn 43709 (R6 / SO6)
� I Resaibed by Depariment of Local Gwemmenl Finarxe
INSTRUCTIONS: DEC ��� �a�
To be filed in person or by mail with lhe County Audifor of the county where lhe p�opeRy is located.
Filing Dates: 1J Real Properfy: Dunng the 12 months before June Il o( the year the deduction is to be e/fe� ive.
2J Mobile Homes assessed unde� IC 6-1 J-7: Between January 15 and March 2 of the year �,�o be eflective.
See reverse side for additional insfruc6ons and qualdications. GIBSON COUNfiY AUBIfi6d
Applicant rorcontract buyer se restrictions on reverse side)
Taxing Distrid, K y umber / legal description Record number
, %� ! a. 7- yoy..00a.7�-oi8
(�[�,� - J � I �,y, �� �a �/5� _ �� Page number
/ �U��(_.l /v •�� / ' c.i
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole I gal or equitable
March 1, wrrent year March 1, current year ownef7 ❑ Yes ❑ No
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is difterent than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Horne (IC Gt.t-�
�ime of mortgagee or contract selier
�
Address of mortgagee or contract seller (number and s reet, ' y, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sheet, city, state, ZIP code)
Doe � � P�/ �unry? What Taxing District? Has this deduction been requesled on
cou '� property for wrrent yeaR�] Yes❑ No
Dra���er NO.Q....�:
�
C�t'(I\0 ...................... COUNTYAUDITOR
Ded ,
20 20 �_ 20 �_ 20 20 20 20
P -P �°
Signalure County Audilor Date
/ We certity under the penalty oi perjury that the above and foregoing information is irue and corred and thal the applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
' !' Siq�ature (owners /ull name) Person authorized by duly exewted Power of Attomey
y j) or by IC 6-1.1-12-.07
I'
Full resident addr of applicant .�— Address of aulhorized person
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