HomeMy WebLinkAboutMortgage_Thompson moo\ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
t FOR DEDUCTION FROM ASSESSED VALUATION
•46? + State Form 43709(RI1/6-09) I -
.,.-- Prescribed by Department of Local Government Finance , •
INSTRUCTIONS: e- a ,�
To be filed in person or by mail. Form�filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. J-i 1 fsEl t2gtO.ditor
Must be filed with the County Auditor or County Recorder of the county where the property is located r'J'
on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the
county where the property is located during the twelve(12)months before March 31 of each year the f! e. •
deduction is sought. GIBBON COUN
See reverse side for additional instructions_ and qualifications.
COUNTY AUDITOR
Ap t(owner or contract buyers (y/rc�t' sonreverse/side) -- ---
1 5 r • spn�'� J SvY. ÷
Taxi Disinc Key number/legal description Record mice/ Page number
f bs` t a�-1p- co•a�oo9(P4 S '/), sE I/� 36 -3-/1 /3-s'1SD
Assessed value of real property as of Mortgage I Contract indebtedness unpaid s of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,=rent year March 1.current year date of application legal or equitable owner?
153 coo CI Yes DI No
II no.what is his/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: Is fiestege rty in question:Annually Assessed
eat Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Naygof gages or con actse0er
Ft a t Se m or a. and Lv
Address of mortgagee or contract se (number ao street, st;'se_
Zr code)
SWI Kr r ? ad ndRJt'i 04 4saa7
Name of assignee or other o e r hold Jr mortgage
•
Address of assignee(number and street.city,state,and ZIP code)
Does applicant own property in any other 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 • I .
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor 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/contract buyer of the aforementioned property on date application is filed.
ur (owners full name Date/ ,,N� 7
3
FO ndennt address of aappplica umber and street. .stateal4 S 'J �
Person aaauwrzea by executed Power of Attorney or by I 6-1
Date(month.day,year)
Address of authorized person (number and street,city,state,and ZIP code)