HomeMy WebLinkAboutMortgage_Feistel a a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
f' State Form 43709(R11/609)
Prescribed by Department of Lod Government France
Ii .,
INSTRUCTIONS: NNNN
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Form feed vat:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. MA`fl1 )ro0quditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months _ t 4
before March 31 of each year the deduction is sought ❑ County Recorder
See reverse side for additional instructions and qualifications. r'arlerWiL
Appfwant(owner or contract buyer-see re strict' on reverse side) O GIBSON COUNTY AUDITOR
e 91 0'4
y number egaI description Record number Page number
84; -2 -/1, - aoo - oo2 .s .lc-o2_y a-a /3 5/ a 9
3
vote of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the appfaant the sole
March 1,current year March 1,current year date of apprncetnn legal or equitable owner?
40 006 0 Yes 0 No
If no,what is his/her exact 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)
Name of mortgagee or contract seller 573/3 .-.
Address of mortgagee or contract seller(number and sheet city,sate,and ZIP code) T� 11
Name of assignee or other owner or holder of mortgage ._ D NO O 'O I
Address of assignee(number and street,city state,and ZIP code)
. Card NO. SIR ?
Does applicant own property in any other If yes,what county? What Taxing District? r 13 . 4'/o &o. �.rs
county in Indiana? ...7 lJ�
El 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 pens of perju c ry 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 re(owner's fug name) 0 ,t Date(month,day,year)
F resident address of t(number and street qi,safe,and ZIP code)
)( /(,$ / h A um ') ,Qic ce 4s.,Lcid,t - V7(059
Person authorized by duly executed Power of Attorney or by IC 1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and sweet city,state,and ZIP code)