HomeMy WebLinkAboutMortgage_Neuman (2) :a._`M1 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION
�-tiI j State Form 43709(R77 I6-09)
'.1--. Prescribed Prescribed by Department of Local Government Finance ;a :t 1a a._
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INSTRUCTIONS: 1 I �— 1. r
Form filed with:
lb be filed in person or by mail with the County Auditor or County Recorder of the county where the properly is located.
Filing Dates: 1) Real Property Must his during the year for which the deduction is sought M t R 48 ly Auditor •
2) Mobile/Manufactured Homes not assessed as Real Property Must Re during the twelve(12)months
before March 31 of each year the deduction is sought County Recorder
See reverse side for additional instructions and qualifications. I
Appfiranl(. b _see l
side)
GIBSON COUNTY AUDITOR
Ta ii7 islect Key num.— legal desoiption Record number Pita number
o-/ —a‘- -sl/— a63- v /— oois dogs a.c
Assessed value of real property as of Mort gage I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant sole
Math n
1,and year Martin 1,corrent year date of appria' /1 legal or equitable owner?
/.5Z UD ❑ yes ❑ No
If no,what is his r her exact share of interest? If owned with someone other than spouse,indkate with whom
If name on record is different than that of applicant indicate below: Is property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller e_.i`Q
Address of mortgagee or contract sefer and steel,coy,state, ZIP code)
•
Name of assignee or other owner or holder of 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? El Yes ❑ No for current year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20_ 20 20
Signature of County Auditor • County Date(month,day,year)
I 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 I con of the aforementioned property on date application is filed. .
Signature name) Date(month,day,year)
F . ant of applicant(number and sheet any:state,and ZIP code)
n 2.1) fS N Hog c . iv ftGa c -rod II 4y, 70
Person authorized by duly executed Pow of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code) •