HomeMy WebLinkAboutMortgage_Spade STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES �6ypnty Township Year
;; FOR DEDUCTION FROM ASSESSED VALUATIOt�'� IL try
1' State Fonn 43709(R11/rag) A�-1
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: AUG 21 2013
Form filed with:
To be filed in person or by mail with the CountyAuditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property Must file dining the year for which the deduction is sought. NO County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file dur e h months
before March 31 of each year the deductions sought d'"�IQPJJII County Recorder
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR
Applicant(owner contract buyer- on 2 e)
o � _pd_l� � — I� a,�Q number _
• r O p- (0—_3a3400-v9r -0 0 `mob � 3 Page rcl
value of real drapery as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole
Ma"- March 1,current C o0 data of application legal or equitable owner?
ASS ❑ Yes ❑ No
If n If owned with someone other than spouse,Indicate with whom
If i SSA DE, A!A NIT Is the property in question:AnntaDy Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 61.1-7)
Tim on-by E
//� f'J ZIP code)
Q[,t1C /^�
� S •
v/ t / S511 Taxing• What Tang District? Has this deduction been requested on property
6 l/� for cement year? ❑ Yes
❑ No
COUNTY AUDITOR
l� a3 J Q 20 20 20 20
County Date(month,day,year)
d foregoing information is true and correct and that the applicant is a resident of Indiana and
ate application is filed.
Date(month,day,year)
ZIP code)
(OWolt5V , IrAP , ti K?66
-12-0.7 Date(month,day.Year)
Address of authorized person (number and street oily,stare,e,.,JP code)