HomeMy WebLinkAboutMortgage_Eckert (4) ,01:1"),4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATI(
'_, ' f. State Fom1437O9(RU 16-09)
1�1
" Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: APR 1 '1 2013 Form filed To be filed in person or by mail with the County Auditor or County Recorder of the county whereth property is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. panty Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file d the tw We s
before March 31 of each year the deduction is sought ❑ County Recorder
Si kist &w e side for additional ins and qualifications. GIBSON COUNTY AUDITOR -`�
Ta ri r•/• Key number/ i- �� Record Page numb��lion
i t. isP oval CO(0 qq
• -. value of real popery as of /Contract indebtedness unpaid as of Mortgage!Contract indebtedness unpaid as of Is the appGmnt the sole
March 1,one year =age e //��//��� date of application Legal or equitable miner?
OCO ❑ 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 different than that of applicant,Indicate below / Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
eta
(-Act l�'I alt -
Address of mortgagee or contract seller(number and street,city state.and ZIP code)
Name of assignee or other owner or holder of mortgage
Aden. .
Doe: C206( n What Taxing District? Has this deduction been requested on property
cour V for current year
Drawer NO ❑ Yes ❑ No
Dee Card NO. --1 ,/ i-1 COUNTY AUDITOR
y L
20 20 20 20 20 " 20
Sgnahse of • t •i• l - County Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is I e and Correct and that the applicant is a resident of Indiana and
?Amer/contract buyer of the aforementioned property on date application is filed.
ignwrp(owne is hA me) ' I Date(rronfh,day,year) -_
Frj`^/residdenntta�addl address of_f aappliicant(numberr a�nnd^sstreet,✓i`-city,state ZIP code)
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Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year) [�
Address of authorized person (number and street,city, code)
,state,and ZIP de) h I \,
•