HomeMy WebLinkAboutMortgage_Wood : . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
;; FOR DEDUCTION)FROM ASSESSED VALUATION — — —
:ef'. tti State Form 43709(R71/6-09
Presented by Department of Local Government Frame
INSTRUCTIONS: = .,.
omr +.. , .
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Properly:Must file during the year for which the deduction is sough. .�pypty Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months J l N L U 1Y
before March 31 of each year the deduction is sought - County Recorder
See reverse sides additional instructions and qualifications.
s/�/�/ -/ sde) iQ 400 � ,� GIBSON COUNTY AUDITOR•' Ay
T . •District AL Kay /legal Pg�K - `-'� Record rwmber Page n ter
,,)41 � Un- /`>-2gLb- LXC'. ;.x"2-D/ 0/ 0' �.0
Assessed rake of real as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the apparant the
March 1,current year March 1,cement year date of aPp legal or equitable owner?
/yi/ ❑ yes ❑ No
If no,what is his/her exact share of interest? If owned with someonlother than spouse,indicate With whom
If name on record is different than that of applicant.indicate belcne Is the perry in question:Annually Assessed
//////yyy111 eel Property ❑Mobile Home(SIC d61.1-7)
art time of mortgagee or contract seller //y� / U' p
CI Address of mortgagee or contract seller(� �t, ,sate.and ZName of assignee or other owner or holder o e 0�lE J //i/ -
E,t'S / /
Address of assignee(number and save and ZIP code)
Does applicant wen property in any other If yes,what county? - What Taxing District? Has this deduction been requested on property .
county in Ind'ana? ❑ Yes ❑ No for anent year? ❑ Yes ❑ No •
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of Cotmty Auditor • I Cor..r., _I nn..r.....–.w_w......•.••_
I/We certify under the penalty of perjury that the above and foregoing infonnatir _ Mien and
owner I contract buyer of the aforementioned property on date application is filet
��o , i ,,� . Drawer NO..........�y..
F I resident address of applicant(number and street,ary,state,and ZIP code) Card `r Q.•
X 5853 5 390N ICanf(S/o /Ai c/7&Person authorized by duty executed Power of Attorney or by IC�1.1-12-0.7
-
Address of authorized person (number and street city,state,and ZIP code) - - -
authorized