HomeMy WebLinkAboutMortgage_Siekman"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN� oun ship Year
_ + FOR DEDUCTION FROM ASSESSED VALUATION �
� � • Sta[e Fwm d3709 (R71 / 6-09)
, w � Pre5vi0e0 by �eparbnerd oi Lnfal Gbvemment F�arm
wsrnucnoNS: NOV 1 9 201(Piierna�c
To be filed in person or by mail wifh the CountyAUditw or Counry Recorder o/ the counry whrae the pmperty is located. F� ���
Fifiny Dates: i) Real Property: Musf fi/e dunrg the year for which fhe deduclion is sought. � County Auditor
2) Mo6ile / Manufactured Hanes �t assessed as Real Property: Must file during the tweNe (� . �
before MarGr 37 0/ eacA year the deduction is sought ❑ Counry Recordu
Seer�versesideloradditbnalinswc8onsandqualifications. GIBSON COUNTY
t(owrermm�traCbuVer�see2strlcbo+ismieversesitlel_ _ • .. �
KeY rnnnbPt � �I Eesv�tion
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ttm,what'shs/hueuGSharaofinfrRSi? "
If fane m remd is 6lterem Ihan ihat of app9rant, MCira9e Debw.
��of��«�,��e� .
Addres of rtartgagee w cmtrad seller numbel and shee4 �f
Nama of assignee or othrl awner w holder of mortgage
AEO�ess W ass9nm (rulmber erN strg�, mY. s�. �d Z/F y/
Oces applinnt awn WcPertY in any dher I If yes.
couMy m Intliana? r-i _. r-i ._
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� «ev�de o�,�r
❑ Yes ❑ No
If o+med wfth sorneone atl�et ihan spouse, Udi�te wiN wham
'!a Me 7bPertY in 0uation: MnuaDY Assessed
Foperty ❑l�fmuallyPssessed
+ Rbdle Hortie pC 6
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�ted m praperty
Yes ❑ No