HomeMy WebLinkAboutMortgage_Morgan STATEMENT OF MORTGAGE OR CONTRACT INTiT SSA, my Township Year 1
FOR DEDUCTION FROM ASSESSED VALUATION
t - State Form 43709(R71 16-09) g
oe
Prescribed by Department of Loral Government Finance
File Mark
INSTRUCTIONS: MAY 1 4 2013
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Form fly with:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought nn'' County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file dofdp months
before March 31 of each year the deduction is sought 111111 County Recorder
GIBSON COUNTY AUDITOR
See reverse side for ditional ins cttens and ifications.
AppuaM(owner or b - on verse side) //�� /t�
fl Key number/ �/ p K! V� Record ben Page nun
- 'oi 3 2J' 8
laM Assessed vah a tract indebtedness unpaid as of Mortgage/Cormact indebtedness unpaid as of Is to appint hie sole
Mardi 1,orient n date of application legal or equitable owner
��� ❑ 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 on record is different than that of applicant.indicate below: I Is the property in question:Amorally Assessed
• ❑Real Property ❑Annually Assessed
. //��/ /�J/y�1y�y�/�,� ////jam/ Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller (9 n ^ c l r ' r / ' r `IIc
Address of mortgagee or contract setter(number and street.city,.tae,and ZIP code) /'
Name of assignee or other ow,wr or holder of mortgage UUU
——_-1
Address d=^— —__. —
OI curry? What Taxing District? Has this deduction been requested on property
-
for current year
❑ yes ❑ No
0) % COUNTY AUDITOR
Card 1O. ...........
01 I I 1 9 .00 20 20 20 20
_ I
/ • / County Date(month,day,)ear)
NW
I/we ce- rti(y rTnder the penalty of perjtiry 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.
naN (o Date(month,day,year)
F resident address of appfi ant(number and street,dry, rate,and ZIP code)
-ia1 S . '(1- a..0 Ln Oviensu Ilc 1N ti%Gs-
Person authorized by duly executed Power of Abomey or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street.ray,a and ZIP code)