HomeMy WebLinkAboutMortgage_Jochim a j`, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township I Year
a�_.,t FOR DEDUCTION FROM ASSESSED VALUATION
'/ State Form 43709(Rill/11-08) F i 1 lit• Prescribed by Department of Local Government Finance
INSTRUCTIONS: e 9 File Mark
To be filed in person or by mail with the County Auditor of the county where the property is located. APR 26 2013
•--^Finny Latest l)4Real-Pmperty--Must-6le during-the'yeeiYor which-the deduction is.sought.-.---.-._.-.-..,.- --.—.._.,.a.._._.,,,,..-_.rs....
2) Mobile/Manufactured H omes not assessed as Real Property:Must file during the twelv (12)months b fore March 31 of each year
the deduction is sought. xJJ�(
See reverse side for additional instructions and qualifications. G I B S O N COUNTY AUnITn R
ApPlr nt(owner or contract buyJ-see restrictions n erne side)
,
7a511-$District Key Mmber/legal descnia,ion Record number Page eft mpnt
�- ,t _ a4 -. 19- 51 - r 1-000 .1 -tog 201'300002171
Assessed value of real properly as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Marl,1,anent year NarGt r t yea/. date of application legal o
i , �5 � or equitable owner?[ Yes ❑ No _._.
I If no,what is his/her exact share of interest? If owned wish someone other than spouse,indicate with whom 7
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
11.E ,l. ' It 1 ,i( 6 t-F 1,0..E-dt
A brass of rpr.Y 9 -r contra seller(number and srva ury,s'a:e,a diZt ) I� , /��'�
-IL It Itj I( ViribInkdi . , ti A/61)(61/111/2. (
Name of assignee or other owner or er of rnortaage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any other I If yes,what county? What Taxing District? I Has this deduction been requested on property
county in Indiana?
for current year? ❑
El Yes No No
❑ Yes
ry
COUNTY AUDITOR II
Deduction approved Li the amount of:
20 20 1 20 20 20 I 20 20
Signature of County Auditor I County Date(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 I contract buyer of the aforementioned property on date application is filed. •
/ Signature(owner's full name)- n Date(month.day.year)
..ull resident addres f applicant(number ands _cC4y s te,, nL t t 1 I 4 �^Ki I ?)b t tb- executed Power of Attorney or by IC o-1.1-12-0 7 Date(month,day.year)
Address at authorized person (number and street citty state,and ZIP code)
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