HomeMy WebLinkAboutMortgage_Bowles STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS . County Township Year
FOR FO DED�UCCTIONN)FROM ASSESSED VALUATION i, J IP !I ),
Presoibed by Department of Lod Government Finarce -
INSTRUCTIONS: Baal 4 2015 Berl`
To be filed in person or 6 mail with the Court Auditor or County Recorder of the county where the property Foy filed
Pe Y tY N tY P Pero'is located.
Fling Dates: 1) Real Property:Must file during the year for which the deduction is sought \M County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property:Must file durf onths
before March 3/of each year the deduction is sought GIBSON COUNTY AUDITOR County Reoarder
See toner reverse side'for additional instructions and qualifications..�/'�� y//���
�.yvac Nr-sye anreverse�iet../`1L[J✓624 bCg.�IUI r`JL-Key num6es/legal desaip— Dot • �� Record nuq�J Pagan I I`'ry ae-1 aescdtot- ceo I
Assessed value teal as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appOnnt the sole
March 1:anent year March 1,arrtep yearn date of aPP� legal o e table
ICll Yes 0 No
If no,what's 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 ❑Amtually Assessed
Mobile Horne(IC 6-1.1-7)
Name of mortgagee or contract seller 2 'gotatiLzaii
Address of mortgagee or aonbad seller(number and tree(et,Aid state,and ZIP code) •
Name of assignee or other owner or holder of mortoaoe. -
R le) .
CANT 3b JLES .
n1^/ dot county? � what Taring District? Has this deduction been requested on property
/ / / for current yeah ❑ yes ❑ No
/ COUNTY AUDITOR
20 20 20 20 20 20 20
( r
Signature of .ty Aucgtor r County Date(month,day,year)
I f 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
//��wy��tttter I contract buyer of the aforementioned property on date application is filed. !�Yh. 1'1�
)0EpnaErre owner's full )_1 zip %I C `V fba /57-7, f/Lv �te(VC1t
�FYuull�rrecsident dress of applicant(number and street,aay,state,and ZIP code) /
Le(aad ulle ,otj fto{ I f/f i /U[ cidvt i /V 4/7 CO 7 rr)
Person oath 6r drily exew of rvmfrier or by IC 1-12-0. Date(rtnndr,day,year)
Address of authorized person (number and street,city,state,and ZIP code). .