HomeMy WebLinkAboutMortgage_Brandebourg _. _
k a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I Count./ I Township I Year I
r.
_ FOR DEDUCTION FROM ASSESSED VALUATION
Pe- Sate Form 43709(R11/6-09)
Pest:.aec soy Deca.^nent of Local Government Finance
i- 49
INSTRUCTIONS: t 1 `.;
To be filed in person or by mail. .F1 eo1l •
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which Inc deduction is souaht. ��` '•
Must be filed with the CountyAudhor or County Recorder of the county where the property is located I County Auditor
on or before January 5 of the immediately succeeding calendar year. CC(i.—V. Cq,p,�Reo•de:
2) Mobile I Manufactured Homes not assessed as Real Property:Must Me with the County Auditor of the r CC�O LV'
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought. -
See reverse side for additional instructions and qualifications. -
Appli- nt(owne_rormil Cbuyer-seeress:ions on rev arse rte GIBSON COUNTY AUDITOR
Dfhhis €Ito rcerAyvievJUr 1
Tip Ditto��a X7'7 KeY nu•:,�^/legal ofion 'I 1'�r.•> �� 'I rte :d r.::moe Page Dec rum
( '- ,(,fl OC/I 2 V /LI-0 01 I ti9y
.I Assesses value of real pr_pet:as of Mortaaoe/Co.: ,imseoteoness unpaid as of Alartoage I Con an:indeotedness unpaid as of Is the aopti- -•the sole
A7a^1 t,were:,; Marn 1.current year date of appil don legal or e^ 'tole owner?
�_) I 71 ,j yes ❑ No
1 It nc ex',is amine:exact snare of interest? . - owned with so one otner than spouse,indite with venom • 1
•
If nam1 e
e�on rewrc is different man meat of acolian:,indicate Delmer. Is the property in puesddr.:Annually Assesses
.V 11.( I0 Real Property ❑Annually Assessed
y� '�•^1 Mobile Home(IC 6-1.1-7)
i-i @o%—.or_z.e' or
l Iza Belle:, 1141 ' 1 r 1' �l ( _
Acore of ma:genee or wmact seller(Hummer• c r'et,city state.a ZIP rap:1
T 1_ r le.asc pate :kid { v . • A -.Ile lki 4715
Name of assignee ar time:owner nolaer of moncace
1 Address assignee(numne:and s ree_ p;c state,and 21?rode)
Does applicant own property in any osier If yes,carat county? Wnat Taxing Gisela? Has this dedu,:,ior.peen recuested on propoe;�e try
FIcdunry in Intlizna? 1 1 for current,wear? ❑ yes !J No
Yes No
COUNTY AUDITOR
I Deduction approved in me amount of:
20 I 20 1 20 I 20 I 20 I 20 I 20
1 Signature cf County Auditor 1 County Date(monm.day year)
- I. I/We_certify under the penalty of penury that the above and foregoing information is true and correct and that the apptitan:is a resident of Indiana and -
ow-te-I-asst buyer of the aforementioned property on date application is.filed.
Sicriatura(o /. - y/ ' 1 Data(mono1 - Y,i 1,
�h1/// I-Z 4 .
-u0 ^e^•z_ o a-^. (ndma_r and s:r°^• d[y,safe.= aZl? 1 •
Iti\e' $ ' '7fate d PatCVO IN 4 7666
Paso a•MO eco v c exe:.ut_e..?over of A`emey or o' Daze(monm,day,year)
1>�� of aG 1p r, rpa:an V ,:, core 7. wo f'lS Vi f lit IN 47 71.4