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.7%, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
a_ : FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R71/6-09)
' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: .a I..
To be filed in person or by mail. i F•I fled;:• I..
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. I a, I.
Must be filed with the County Auditor or County Recorder of the county where the property is locate I •uditor•
on or before January 5 of the immediately succeeding calendar year. •k Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the t Lilt
county where the property is located during the twelve(12)months before March 31 of each year the a1:4
deduction is sought. J
See reverse side for additional instructions and qualifications. ,f/�jj�
Applicant(owner or contract buyer-see restrictions on reverse side) j�'r
BOBBY VON MCGOWAN,JR. &SAMANTHA J.MCGOWAN GIBSON COUNTY AUDITOR
Taxing District Key number/legal description Record number PagiuiOUtaPnt
26-20-02401-000.045-003 201300002377
Assessed valve of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtednes-6.1-9_�/apa id as of Is the applicant the sole
March 1,current year Marco 1,orient year da applicab legal or equitable owner?
$46.100.00 . 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 an 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
BANK TRUST FINANCIAL CORP.
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
208 N.MAIN STREET,HENDERSON,KENTUCKY 42420
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city state,and ZIP code)
Does applicant own property in any other ti If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ yes No ❑ yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
t 20 20 20 20 20 20 20
-ti
Signature of County Auditor County Date(month,day,year)
I 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.
Signet :(owne s hill name) Date(mo ,Oa year)
A._ _,�/ 4/_--- .∎ , ae t_<..... t J. • C • r I
Full residen address of applicant(number and or'city,state,end ZIP code)
5113 S.LINCOLN STREET,OAKLAND CITY,INDIANA 47660
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,state,and ZIP code)