HomeMy WebLinkAboutMortgage_Powers (2) a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
r"' FOR DEDUCTION FROM ASSESSED VALUATION
Preto Prescribed by Department m/609) '
^ ✓..,� State FM.W try Department 0 Local Government Finance ( r„`
2 Fil- (a
•NSTRUCTIONS: ,•
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Form filed wrrilyth�r:J1
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought DE' fl 2O:W my Auditor
2)Mobile/Manufactured Homes not assessed as Real Property.Must file during the twelve(12)months
before March 31 of each year the deduction is sought. n,..J V Recorder
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See reverse side for additional instructions and qualifications.
Applicant(owner orcontracf ft /see restrictions on reverse site)
r7�(/ GIBSON COUNTY AUDITOR
Ta ' Di2trict Key number/legal description --..•rd number P-.e
number
? - Ol— 40 d`-0�- /•3 _ o . ; , 0 L , 5b7
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract Indebtedness unpaid as of Is the applaant the sole
Marts 1,arrerd year =mail
arnent year date of appg abort _ 97 legal O lade
Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,Indicate with whom
If name on read is different than that of applicant,indicate bebw:
Is the property in question:Annually Assessed
meal Property ❑Annualy Assessed
a"-A Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller , �
i
Address of mortgagee or contract seller(number nd street.city,state,-n•ZIP code)
Name of assignee or other owner or holder of mortgage _ __--
Address of- and sweet tlry,state.and ZIP ecrm / D
a �./ G.I`/-
Doesa••Icantownpropertyinanyother If yes.what county? What Taring D'c Drawer \Q••• ••••••••• —
county m Indiana? ^ /
0 Yes ❑ No oC1
III_ COUNTY AUDITOR Card NO. �""'••
p .`"YNn'
Deduction approved h the amount at 6/ Q 1
20 20 20 20 2t. 20 20
Signature of Cmmry A�ditor County Date(month,day,year)
0— i
I/We certify under the penalty of perj �.t the abov: :nd foregoing information is true and correct and that the applicant is a resident of Indiana and
` - owner/contract buyer of the aforeme • S property( date application is filed.
X :nature(owner's MI name) iii Date(month,day,year)
X'� \/Ful resident ad• •....epgM- ttc.tmbebertr/a'nd sheet, �Y-.{-te, ZIP code))
'1
COO 'duly IC executed of y w by IC 6-1.1-12-0.7- c 4n 1W 217C 7 0 Date(rrronlh,day,year)
Address of authorized person (number and street,city:state,and ZIP code) .