Loading...
HomeMy WebLinkAboutMortgage_Almond a"vim. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS i r11 .117. .ip I Year e "$ FOR DEDUCTION FROM ASSESSED VALUATION n' State Form 43709(R10/11-08) ,,,, ll Prescribed by Department of Local Government Finance MAYS 2014 INSTRUCTIONS: To be filed in person or by mail with the County Auditor of the county where the properly is located. Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. GIBSON COUNTY AUDITOR 2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months before March 37 or each year the deduction is sought. See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) \v rrt\ Cs . nil 1� Taxing District J Key number/legal description ��� _ Record number Page numbe k . G3rav�cAn taco—t&2-L (o a9oiLt r�4� Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole March 1,current year March 1,current year date of applica � 2 (,�- legal or equitable owner? tSDl(y';n\� J, 6❑ yes El 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) tame of mo ge a er ayetitau V an Address of mortg�or contract seller(number and sire t.d .s, a nd ZIP code) SO 2 GU I I-e (Tt■1 3'1`�� Name of assignee or other owner or holder of mortgage t 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? for current year? ❑ Yes ❑ No ❑ Yes ❑ No COUNTY AUDITOR Deduction approved in the amount of 20 1 20 20_ 20 20_ 20 20 Synat were o�r County Date(month,day,year) 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/contract buyer of the aforementioned property on date application is filed. Signature(owners full me) Date(month,day.year) > 5 01--1(---F sident ad s of applicant(number and street.city,state,and ZIP code) 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.city,state,and ZIP code)