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HomeMy WebLinkAboutMortgage_Thacker (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year ;4�°'s ') FOR DEDUCTION FROM ASSESSED VALUATION 'z I. State Form by (R10 Department,� •' Prescribed by Department of Local Government Finance IP INSTRUCTIONS: File Mark To be filed in person or by mail with the County Auditor of the county where the property is located. APR O 9015 Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. Hf f� O L J 2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months before March 31 of each year the deduction is sought. �(///(1JJ�0� � i,�1� See reverse side for additional instructions and qualifications. r^"'^-7-"^^'^ t nt r or contract buyer-se s► ns onrev se side) GIBSON COUNTY-AUDITOR IrIVCk %r r.hn r IC0A J . /] �Jj Tazug Disidd4 ) Key number Ilegaldes room . \o� 000 . /�)ej- /M{ I- RC/�d�u�b0t�- Pia Assessed) Assessed value of real property as of �J Mortgage/Contract indebtedness unpaid as of Mortgage/Contract Indebtedness unpaid as of SIs the applicant the sole March 1,current year March 1,current year ` date of application legal or equitable owner? 14(p1ai1 . w l-1 yes 0 N 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 III Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller • 1 vl or+cigc�e ACE S f 2� o/(` cl i et&UNJ ■Qn J Address of mort9 ntrad seller(number and street.city state,and ZIP code) ) 501 J Cr 6+0a) `�Crt (1-€9,_ L/31 vd,.� t O Q�I( p 'i (h1/4-1 i 5 Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city state,and ZIP code) Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction for ❑ Yes ❑ No been requested on property many in Indiana? ❑ 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. Signal owns IuO e) Cc I Date tInt ,day.yecr),5• Fug r ant addre o plicant(nu bqr aa�ndn�d--Vst�reet,city.star n ZIP code) 1"�1 1 \ ' `1�;ti..1K t .q 1 J c�. • l0q , anO)acol \Dev 41(4049 Person authorized by duty executed Power of Attomey or by IC 6-1.1-12-0.7 Date(month,day,year) Address of authorized person (number and street.city,state,and ZIP code)