HomeMy WebLinkAboutMortgage_Besing (2)-.+..*• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou wn ' ear
x,, ... FOR DEDUCTION FROM ASSESSED VALUATION ��
State Fortn d3709 (R8/ 2-07)
� Prescnbed by Deparimenl of Local Govemmeni Finance
Mq� dn� 2009
INSTRUCTIONS:
To be frled in person or by mail wifh the CountyAuditor of the county whe2 the property is located. �
Fding Dates: 7) Real Property: Dunng the 12 months befwa June 11 0( the year the deduc6on is to be eflective.
2J Mobile Homes assessed under IC 6-7.7-7: Behveen January 15 and March 2 0( fhe year the deduction is to b eA�a��
SeereversesideforadditionalinsWctionsarMquali�cations. GIBSON COUNTY AUDITOR
Apd�cant (owner or contrad buver - see rastnch'ons ar reverse side) .
�d Disina ey number I lega
�_���� a c�- �c
�sed rdue of re� poperiy as ol March 1, amenl year
r�
ro, what is his / her exacl share of irM1erest?
It n2me Wl
Name of m
naa��: �r
canVact seller
- o oal.l�R3-�o I o Coc_
�e / Contrad iMebledness unpaid as M March 1, Is Ihe applimnl Ihe sde legal or equiUHe owne(t
Yea� _ . __ _ _ _ .' ---
\ l y t�t� t� - - �
mnlrad seller (number ar�d street. ory. 9ate.
Name of assignee w dher wr�r or holtler of mortgage
Address of assignee (number aiM sGeet, city, sfate, eM ZIP mAe)
Does appliwnt o.vn property in any other If yas, whet county?
counry in Ind'ana?
❑ Yes No
ction approve0 in the amwm of:
20 0 20 �� n 20 _
9
Whal Texing D
COUNTY AUDITOR
.ry'��
I I We certify ur�er lhe peri�lty oi pe. �ui ihat ihe above and foregoing infortnation is We a�
I�diana and owner of tlie aloremenbrned property on March 1, 20
�reW�rj�° wneJslNlnartre)
� _dC C.�)l.0/il� S �
u revd nt address of applicanl (number and sfreel. cd . state. arrd ZIP code)
�RSis s 4�So f �ahd,�2oed s� �7�
noriied by duy exeCUletl Power ol Altomey or by IG�b�l.1-12-.0]
aulMraetlpersm (numberaMsLeeGcrty.sfate.aMZlPwde)
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