HomeMy WebLinkAboutMortgage_Falls (6) rf STATEMENT RDEDU DEDUCTION MORTGAGE S ES OR CONTRACT ZION F Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
c. - State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: APR 2 9 2014
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Ferret N�with:
FRig Dates: 1) Real Property:Must file during the year for which the deduction is sought. Court Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the 1 b
before March 31 of each year the deduction is sought - County Recorder
See reverse side for ad.itional instructions and qua! .tions. �7f^/ 'I//1I1//{/1,L,��GIBSON COUNTY AUDI-OR
Appbcanl(owner 54.�..-buyer-see • -an re j -- side) C\:� --�-�'L/ Record number
Taring p Ct�'K"��„(1 Key^amps 1lega?scrip ii /�V LW• r `^+-W t0 c 113 Page number
( aP
Assessed value of real property as of �ICjf/OAbngagee I Con btedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the app&rant the sole
March 1,cared year Marti 1,w date of aPP�ton Iegal or equtable miner?
gs oar) ❑ Yes ❑ No
if no,what Is his/her exact share of interest? / If awned with someone other than spouse,indicate with whom
If name on record is different than that of appaane indicate below Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
. ^ l ������/fIrJMo obbilleenI-kxn/e�(I�C�(i1.1-7)
Name of mortgagee or contrail seller it Tr) it, — / / „ I e/V "V /1 0 Y$/K.l.l tit
Address of mortgagee or contract seller(number and street,city,stare,and ZIP e) //V//LlNlF�'l.}
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,cry,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? for current year?
❑ No
❑ Yes _ ❑ Yes ❑ No
TY AUDITOR Deduc
Deduction app Ni O �,l•'�,
Drawer •••••••••
20 1 ! a1DCIP 20 20 20 Card NO. .
Signature of Cr 4,�1 O ill 0/90, d County Date(month,day,year)
I/We cerd. Fw � -.�w.r,.,t u err we aoove and foregoing�ormation 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.
��9�r;turr/e//`�-.leh full.name) Date(month,day,year).e J220
P reside add)"ess of a (numberand street,d y,state,and ZIP code)
fr/cio- _S- ins OF llAbt.,J (1 -1 —774.1 `/7Cc0
n
Person authorized by duly executed Power of Attorney or by IC 1 2-0.7 Date(north,day,year)
Address of authorized person (number and sheet,dy,state,and ZIP code) .