Mortgage_Steiner x STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
C;, FOR DEDUCTION FROM ASSESSED VALUATION
State Form U/6-09)
Prescribed by Department of Local Government Finance I —F ET)
INSTRUCTIONS: rp-�r( yy
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.APR 1 r7 L U I t
Filing Dates: 1) Real Properly:Must file during the year for which the deduction is sought ❑ County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months before March 31 of each year the deduction is sought. - rriyRecorder
See reverse side for additional instructions and qualifications. G I B$ON COUNTY AUDITOR
ITDR
limns(owner or contract buyer- rrsrri�oons verse side) �
U Y -6- 1i�� 7 •
Taring District Key number/legal description Record number., Page number
a(o - 11 - x/ - 1{00 - Dot. 3407 ^ off / c-oi3 / 8 / y
Assessed of real as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the apparent the sole
Math 1,amen year March 1,current year date of appacatioei legal or equitable owner?
If no,what is his/her exact share of interest? If owned with someone other 0 0 ❑ Yes ❑ No
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
Mobde Home(IC 6-1.1-7)
Name of mortgagee or contract seder
7 Az
Address of mortgagee or contract seller(number and streets state,arch 2IP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) -
NE 5E al - 3 - ) a- ioA c—
Does applicant own property in any other If Yes,what county? What Taxing Datric -n Dmperty
county in Indiana?
❑ Yes ❑ No DI aiyCl-1\r I
o li
p
COUNTY AUDITOR
Deduction approved in the amount of: �Card No. / ?/ ••.
20 20 20 20 it (�/ -7 /`,(f(\•I ••.•..
_r trVl`J —
Signature of County Auditor . x County _
//4
I/We certify na of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana iii,.
owner I contract buyer of the aforementioned property on date application is filed.
I Fuii;r (owners fu'name) _� Date(month,day,year)
Full reside addre applicant r(nynuumSer and street,city:state,and ZIP code) /1(� \, 1 ---q_. [ (
Person authorized by duly executed:etl Power Attorney% by IC Gi.1-12� c t 'S y I ` l iii ±_ro "l C9 day,year)
Address of authorized person (number and street My,state,and ZIP code)