HomeMy WebLinkAboutMortgage_McCandless (7) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE T unty ownshi P Year
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FOR DEDUCTION FROM ASSESSED VALUATION
State Form /
Presmbed by 43709(R71 Deparrment of a-09)Lod Govemmed Finance
File Mark
INSTRUCTIONS: OCT 7 201 yam filed With:
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 Property:Must file during the year for which the deduction is sought n County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the tweh
before March 31 of each year the deduction is sought r 't ❑ County Recorder
GIBSON COUNTY A m1TQR
See reverse side for additional instructions and qualifications.
Ap (owneror a/ arestici,Y rei e rse side) e
) fACay
Taa
Distict r Key number I legal description Record number Page number
2‘ (c /l hJ. _ 30a - 00% 6/ S-0Ag 9,o1Y 393a
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Manic 1;end year March 1,arrent year date of application legal or equitable owner?
A 5, coo ❑Yes ❑ 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. I Is the property in quest:Annually Assessed
-- —. _�. .t--I Ann,nth.Assessed_
Name of mortgagee or contract seller '? 6
J,U Drawer NO ��l`7
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) Q
Name of assignee or other owner or holder of mortgage Card NO. 3 /
Address of assignee(number and street,city,state,and ZIP code) f ll��//
Does applicant own property in any other If yes,'tat county? • What Taring District? Has this deduction been requested on property
county in Indiana? year?
El ❑ No for current yea
❑ 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/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.
Sig lure to .lull r)i l(6- ^ ` /J/ l Date(month,day..Year)
U FRAI resident address of applicant(number and street,t,,(sly, and ZIP code) /t4_1 e—ra 06
7641 - S o r t i l t c A 1/ // D2 1/74 7D
Person authorized by duty executed Power of y or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and sheet,city,state.and ZIP code)