HomeMy WebLinkAboutMortgage_Maikranz (3) a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e:., '_
p�-��;; FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09) it g
Prescribed by Department of Lad Government Finance p 4p1 C'
r I 3e1S1.1
INSTRUC71ONS:
Form Ned with:
ro be filed in person or by mail with the CountyAuditor or County Recorder of the county wham the property is located. lt'1(
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought O C I 2[Sj 2 3nty Auditor
2)Mobile/Manufactured Homes not assessed as Real Property:Must Re during the twelve(12)months
before March 31 of each year the deduction is sought ❑ Co my Recorder
See reverse side for additional instructions and qualifications. 1A -
Applicant(owner d
eroroontrabuyei-see ' ' on reverse side) GIBSON COUNTY AUDI I On
awg D'uh:l Key number l legal description Rewrd number Page somber
Ole/ g& -/9-i? - 103 - oDD. 636 -a .2. 6, I `E .3.5- / ca
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/p application-3 indebtedness unpaid as of Is the applicant the sole
Match 1:current year March 1,current year date of appr�0on-3 S legal or equitable owner?
L{ ° .t1 ❑ Yes ❑ No
If no,what's his/her exact share of Interest? If owned with someone rimer than spouse,indicate with whom
If name on record is different than that of applicant,hdicate below. Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
• Mobile Home(IC 6-1.1-7)
Name of mortgagee et contract seller
Address of mortgagee or contract seller(number end street,city,state, LP code)
Name of assignee or other owner or holder of mortgage
Address a f a ignee(number and street,city,state,and ZIP code) ^ -
d-a- -a- to 7 r/ •
/� ;-r
Does applicant own property in any other If yes,what county? • What Taring Dchicta 1 ' Ark£4Its z �U�F R i rt --- -
county in bdara? ❑ No
❑ Yes
bUOCAd
COUNTY AUDITOR
Deduction approved in the amount of: • I�{, 1`-3516
20 20 20 20 21 Jr c/o v2 5 3
. .. dccurry AU6Nr ` County
Idtkv‘-4-■t_" I
e 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
• er l contra. • 1 of the lafo e�rnee/p)/ttii�oneed/pro on date application is filed.
11 s NN r Date(month,day.Wad
I
00)1 V of I `l-Vra l6eeLfaly b4 i° /I l 4, 1 I W r
Person authorized by duly executed Power of 1 a1718,or by IC 6-1. -12-0.7 1 Date(month,day,year)
Address of authorized person (number and steer,cM.state,and ZIP code)