HomeMy WebLinkAboutMortgage_Deputy (2) i.s STATEMENT
DEDUCTION IO OF MORTGAGE S ES OR CONTRACT IN tspj)ntY Township Year
FOR DEDUCTION FROM ASSESSED VALUATIO
•Y'• t'. State Form 43709(R71/6-09)
• Prescribed by Department of Local Government Faance
INSTRUCTIONS: JUN 5` 2013 File Mark
To be filed in person or by mad with the County Auditor or County Recorder of the county where the property is . .t.. Form filed with:
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. A ri County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must file d •�.,��: 1iQ?'t px oaths
before March 31 of each year the deduction is sought County Recorder
See reverse side for additional instructions and qualifications.
GIBSON COUNTY AUDITOR
"_",(p/���'J1_f//f- I 4 l�,of• . �.h- Rer�g/ry1 /g� /_
Assessed value areal.,..., as of Mortgage/ tract indebtedness unpaid as of age/Contract indebtedness unpaid as of Is the applicant the sate
March 1,current year MarCx 1, date of application legal or equitable owneR
ODD ❑ Yes ❑ No
If no,what is his/her exact share of interest? / I 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 5-1.1-7)
Name of mortgagee or contract seller _
thlitta
Address of mortgagee or contrail seller(n street ---- ,de) 1
Name of ass+nn----- '
apt ......•
Address it • .0 r aw er \O•••�••/•�•^J�7
Does applit 11 l ifi v..`•••••••• i I What Taxing District? Has this deduction been requested on property .
county in In O. ••••• for current year? ❑ Yes ❑ No
card
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-0[,�0,(1Lo'� - COUNTY AUDITOR .
Deduction apt WWW
20 20 20 20 20 20 20
'r County Date(Ole DS
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 aforem boned property on date application is filed.
signature(loon name) Date(month,day,year)
< wti l� 13
utl resident address applicant(number
.4" street a1y,JJ��te_ rP il..
1 q Il S IJG t � Asctlunc�sco Ili rl1loyy
Person authorized by duly executed Power of Attorney or by IC 6-1.A-12-0.7 Date(month,day,year)
Address of authorized d person (number and street city,stare,and ZIP code) .