HomeMy WebLinkAboutMortgage_Hornby (3)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED V��� ��
„ s�e wrm as�os (R�i i c�)
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�� File Mark
�VSTRUCTIONS: ��(1'/ U n�
fo be filed in person w by mail wdh fhe CountyAUdita or Counry Recorder of}h��Offity �ere�the property is located.
Filirg Dates: 1) Real Property: Must file durirg the year (or which the deducj �' /is soughf.
2J Mobde / Manufactured Homes rrot assessed as Real Prope}fy: Hk��he hvelve (72J months
before March 37 0/ each year Ne deduction is sought �
SeereversasMefora�ditionalin;vuqyon�andqual�catpns. GIBSONCOUNrv���,..___
ee � �r rea� wovenr � a
i. ar�eN year
1f M. NTd� 61Y5 / h¢f ¢10CI51W9 Of VIfCR52?
If name an
mortgagee «mntrad se4er
w cantrad se0er (number and
Name of assignee a atm wrier
AdCress at amgnce (wm6rlaM atree4 Wy. s+afe,
Ooes app6�nt ovm popC[y in eny dher
countyinlMana? n_ . -��
ge /
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pra���er �0•........
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1/ We certify under e penalty of �ury Mat abov a
ovmer I mntract buyer of t�e a(ore entioneC operty
U appGrantwneRfDeranA sUeet. aty, sfate.
orbylCG1.
(numbereritl sbeet dry. state.
06 ,3c�oal olD-vo/
�t�dne5s unoeb es oi Mongage / ConuaG mOeMe�
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COUNTYAUDROR
2� 20 _
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Counry
Fwm t�eE wnh:
e�unry Auditor
❑ Counry Recorder
uRn�tl as W�ls Ne a
kgal or
Yes U No
Is iM prop�ty in Question: Mnually Asussetl
❑ Real Roperty � ArmuallyAssessed
Has Nis tleEUCSm Deen
tor WrreN yea(?
�_
D2Ie (mOnfh. tlaY• Yea�)
m propelly
❑ No
�_
nd foregoing in(ortnation is We and cortecl arM that the applinnt is a resident of Indiana aM
date appliration is filed.
Date (morph, day, ysa�