HomeMy WebLinkAboutMortgage_Barretto (3) /is4,11 f.. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS _ County I Township 1 Year
,�' E FOR DEDUCTION FROM ASSESSED VALUATION
I % 1 2
State Form 43709(R14,1-23) Gibson � 'Q /'V 22,�,
`, Prescribed b/Department of Local Government Finance t— (�C�
File Mark
INSTRUCTIONS: To be fled in person or by mail.
Form flied vrth
Filing Date Form must be completed and dated in the calendar year for which the deduction is sought
Must be filed or postmarked with the County Auditor or
e .
Taxing D'st I j� y n i rbe^O-deschp..o- _.-4 p I Record number 'P
O 2 L ^12 t -ooI. Tt2 --o ZO 1 Rage number
2-0 2 2 i 2-'9.3-N----
As=ass =_'u=c`reel pre-art _s- frOr:Cage.i Co.:'act indec eo'Ess a^;;a as a !Ito-ga^e!Canner'_i-debte.. u-paid as e, Is the r '-Pl"cant the ne
: y 'c �` i p �� �leaa'o' rtabre ov:nr?
ass=_ssrani dale.current yea- assessment dare cu^Ent yea- data on ,may
r3 9 V . IJYes E No
- if re v.-hat is h s!he,EY.aG!St13'e o`interest'?
If owned.cite s ..eone of e-than spouse.indicate with whom / \
If na^'e en record is efferent than that o`app"a _e nt.ir.•c . bele:: ' j I th property it question Annually Assessed
I' Real Property ❑Annually Assessed
` Mobile Horne(IC 6-1.1-7)
S V a` C _
Address of inert= nee ne . o tract seer(ru r and street.cif/stale.and ZIP cod-r _— -- —
_ AUG 1 0 2022
,.:a-re c'assignee.O other ov.ner or ho'da-Of mortgage ---
Ad^ass s r.�
cf ascree( mter e street.
d se:.city:state and ZIP coda GIBSON COUNTY AUDITOR --- 1
i
I
Does applicant oar p-operty in any I I`yes a.hat county', I t--.hat Taring D st-lct7 !on the deduct o b n requested I If yes state amount of d�+duot:on !
other count/ I .
for 1
in Ind ara7 ❑Yes No I current year, i Yes E No !
A person is not entitled to this deduction unless the person has a balance on the persons mortgage or of tract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR ---
Dadu t o•r acp-oved in the errou-t cf ----- ----i
20-- 20 20 20 20 20 20
i
Sc' r• tore of County A.ud,to• I County t Da' (,c '• a/year,
al A - I 1 Off . to -2.. 22
I _
I We cent under the penalty of perjury that the abo regoing information a and correct and that the appl cat t is resident of Indana and
owner/oil tract buyer of the aforementioned property • appica:ion is filed.
S:g^atu•! A r'',erne) it: ( q3
FL' r VW(C-of 1Qf:(ruin__ end street c!7 state e-d ZIP code. ' l l yt?C• '.
Re-sun autt`er:ze_by duly executed Pore,of Attorney cr b/IC 6-1 1-12-C 7 i Date(month.day year;
i
!
Address of authorized person (rumber and st'=_et.city state.and ZIP code?