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HomeMy WebLinkAboutMortgage_Sloanti "`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township , Year __ s FOR DEDUCTION FROM ASSESSED VALUATION • Stale Fwm 43709 (R11 / fi-09) �' � PresaiOed Oy DePa�nt of Loral Govemment Finarxe File Mark INSTRUCTIONS: CC To be fi7ed in person w by maii wiM the CounlyAWitw or Counry Recorder o! the counry where the p�operty is bcakA.-B 9 Fo � wiih: F13ng Dates: i) Real Property: Must file durirg the year for whirh the deductian is sought Counry Auditw 2) Mobile /ManuFactumd Homes not essessed as Real Property Must fiie dunrg the M1vefve (72) mo�6s�. befwa March 31 of each year the deduclion is sought. �^tY R�� Seereverseside(oraddrGonalinstrucUonsaMqualification�. _ GIBSONCOUNTYAUDITOR ������� �� ro, whe16 tis / her eraG sAara of interest? a�,� If rwne m remd is S�amt Nan that o( aPP�+4 uMifate Delmr. of nvtpapee a mntrad =°"— _ " � a,�`�......... pra",�, �O•••••••. a,�a.......... ��ra�o- �'��� ��!'�� � No � .�. 20 amount of. � I Racord rwmb� '3-a�/ � rc �a wm, �� an� w� �cu�se. COUNTYAUDROR 20 20 _ 20 � . n I/ We certy urWer ihe penatty bf perjury thar,fie above arW rnvner % contrad buyer of the afaemeMbned property on da arenuelo !s/u�reme) // stare, anC LP ootle) Cy OWY executed Power o(ManaY w M IC Address o( aunmr'¢etl perso� � Page number �� � Yes ❑ No I5 �he D�OMY in Ouestion: Mnuaoy As5esse0 I,�] RPaI Ptoperty Q Armually PsscSSed � P�Y ❑ No ZO _ � 20 _ �� ��. infomiaUon is true and cortect and that Me applirant is a resident of IMiara ard ion is fded. �l: Y��