HomeMy WebLinkAboutMortgage_Longabaugh .1. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS county Township Year
ti;: FOR DEDUCTION FROM ASSESSED VALUATION
' ' State Form 43709(R1116-060
Prescribed by Department of Laval Government Finance
He Mark
INSTRUCTIONS:
76 �AN -
{ .1 !S be filed in person or by mail with the County or County Recorder of the county where the property is local
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought ❑ Coun Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)month I i wm,
before March 31 of each year the deduction is sought I, , ��nnin j,County Recorder
See reverse side for additional instructions and qualifications. ,�(v.., GIBSON CO. • - • i i -
Ap t(owner or contract buyer a-�I �e)� /`-O ,may
1 /J
Ta ng Disbirl Key number/legal description Record number Page number
LIJ� Z ` u 02(0 05 - 58 Dy a - 00.Z . 30 -3-o1 20 / C 8 ?
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
Manic 1;current year March 1,current year date of applicationn legal or equitable owner?
.5 o O V ❑ 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 Is the property in question:Annually Assessed
❑Real Property ❑AmluallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contact seller• �/a�/1� �f�/
I' le2X,
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) �'-
-_
Name of assignee or other owner or holder of mortgage
Addr of assignee(number and street,c%state,and ZIP code) Dr (/'1
. PT Al D Li k - ( —/e2 3 ,o o 4- �. Drawer I\'0.........��.ff `\
Does applicant own property in any other If yes,what county? • What Taxing District? �++•.
county in Indiana? .
❑ Yes ❑ No Car d NO
COUNTY AUDITOR ""
Deduction approved in the amount of. - -
20 20 20 20 20 20 20
Sgnanu�of CamtYAtore idivutcei County Date(month,day,year)
I 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/`nabirr)e'...(oo�v`m�eh MI Inane) Date(month,day,year)
II resident address of all t(number and street, • --le,and�jZIP-.,.(•e')/
.591 el N- TrZYPc`4-f ed. t:2 ft-4 TA/ Lj ?666
Person authorized by duly executed Power of Attorney or by IC 61.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code) .