HomeMy WebLinkAboutMortgage_Parsons (2) a, . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION jl �\Stafe Form 43De rtm/boll) 1 t1
Prescribed by Department of Loral Government Finance [)
INSTRUCTIONS: pp pad
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. F o MAR 1 fitly,
2014
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought ❑ County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months
before March 31 of each year the deduction is sought •fA r
See reverse sid for additional instructions and qualifications. 0 illy
� ,_,/y /-1 /����r//� �/� /''j(�/J GIBBON COUNTY AUDITOR
Apf gym( a_/10/ - t•3 /.��e) �✓ r-C 94 (7C2 0 ) Cif
;;p Key number/legal description (7// mN number Page num0?G -d - tcn- a0/ a2/- OdV l�of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as Is the appftant the sole
1,anent year March 1,current year date of a vyyy1� legal or equitable owner?
❑ Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of appecan4 indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
_,,anee •
Address of mortgagee or contract seller(number and street city.state,and LP
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and
—
cO I"?
. Drawer NO
Does applicant own property in any other I -las this deduction been requested on property
county in Indiana? ❑ Yes ❑ No I ,/"J� w accent yeah
�C�a�r)
Card NO. I 1 �Y ✓ ❑ Yes ❑ No
Deduction approved in the amount of �/"'r� S"� �
.#ail/coo. —
20 20 ti I Li., I 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 contract buyer of the aforementioned property on date application is filed.
Sig - �o hN � Date(nnwrdn,day,year)
F f /num card street,^ ,state, - .L =
•
P cod
�i�, �
% - / r X22) a !_ !a:AO I V 05 a
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street ci))state,and ZIP code) •