HomeMy WebLinkAboutMortgage_Halbig :l�j STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
i ' FOR DEDUCTION FROM ASSESSED VALUATION
LideState Form 43709(R11 —
Prescribed by Department nt of of Local Government Finance _ i i 1n.
iI Ma
INSTRUCTIONS: Form filed with:
rz
To be filed in person or by mail with the County Auditor or County Reco&er of the county where the properly is located JA 1!_Il two
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. 1 J ud-rtor
2) Mobile/Manufactured Homes not avcessed as Real Properly Must file during the twelve(12)months
before March 31 of each year the deduction is sought El County Reorder
See reverse side for additional instructions and qualifications. w
owner or contract buyeLre ybons on reverseslde)i=.y . GIBSON COUNTY AUDITOR
Distrrl Key number/legal description Rend number Page number
A (o - 1r,a5 - boo - coa. .o ?- y-oa.S A0l3 /7 01.6
Assessed valued real proper,Y as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Mery 1,current year Ma 1,aorent date of apprxation legal or equitable owner?
63, 00b ❑ Yes ❑ No
It no,what's his/her exert 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 the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Named mortgagee or contrail seller I I� . � _ _- - — I
Address of mortgagee or contract seller(number and street,city state./-nd ZIP code) )
Name of assignee or other owner or holder of mortgage O
Address assign,(number and street,city,state,and ZIP code) D 1 it\\ C 1 I •••.••.
i0 fit- NI.J ?,5 3 / 1 a . 004L f _
.
Does applicant awn in any other If what nun • What Taxi District? .'...
PW property Y yes, null C:11 (1 NO. .....
county in Indiana? ❑ yes ❑ No .
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
SigrhaN d 1E 7 '
• County Date(month.day,year)
I/We certify under the penalty off rpe_rj_u'ry that thee above and foregoing information is We and correct and that the applicant is a resident of Indiana and
owner,/contra buyer of /mentioned property on date application is filed.
sig. eh 1I A// Date(month,day,year)
-89 t 'l ��m �/ !t�!7 Ole 47U-1.0
resid Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,veer)
Address of authorized person (number and street city.state,and ZIP code)