HomeMy WebLinkAboutMortgage_Bennington a_.: STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cain Township Year
CoiFOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(RI1/6-09)
Prescribed by Department of Loral Government Finance it = j i Alb.
INSTRUCTIONS: t I - -
F filed with
To be filed hi person or by mad with the County Auditor or County Recorder of the county where the property is located. Iy7W t
Fling Dates: 1) Real Property:Must file during the year for which the deduction is sought ll R 1 I 2016 County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)mamas
before March 31 of each year the deductions sought - ❑ County Recorder
See reverse side for additional instructions and qualifications. •wa m•"'-iii
b�°"t(0" "4 `, T GIBSON COUNTY AUDITOR
T ' atrial , Key number/legal description /,'�/ �"'fv Germs/ Record number Page number
a6 - l3 - /3 - 3o0 - 00/. DR - eo6 20 /5 87.5
Assessed value areal property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the appacont the sole
March 1:current year March 1,accent year date of application legal or equitable owner?
/016, QOD Dyes El No
t what at'a his/her exact share of interest? If owned with someone other Intl spouse,indicate with whom
If name on record is different than that of applcant.indicate below: Is the property in question:Annually Assessed
❑Real Property ❑AnnuallyAssessed
- Mobile Home(IC 6-1.1-7)
Name of mortgagee or contact seller 7l(
.r/3
Address of mortgagee or contract seller(number and\•stee;city,state,and ZIP code)
_ .
Name of assignee or other owner or holder of mortgage __
•
^////��� _
Add of assignee(number and sheet,city,slate,and ZIP code) // '1/�
'% NE 5a) /3 - A - 7 /A c Drawer NO 45 0(
Does app scant own property in any other If yes,what county? • What Taxing District
county in Indiana?
❑ yes 0 N Card NO.
COUNTY AUDITOR .
Deduction approved in the amount of •
20 20 20 20 20_ 20 20
Signe of County Auditor County Date(month,day,year)
/-
I I We
penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
y r Sig (owner'fW name) Date(month,day,year)
jV ��tu resident s of apprimnt(number and sate,and ZIP cede)
p�Q`\a'{ % . ° �' 72 rS l�cR �4 ti p, /, G, a
Person authorized by dirty executed Power of Attorney or by IC 6- I-12-0. Date(month,day,year)
Address of authorized person (number and striae;city,state,and ZIP code) .