HomeMy WebLinkAboutMortgage_Strickland (9)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Town:
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� FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709 (R71 / fi09)
�' Presaibetl by DepartmeM at Loml GwemmerG flrmnce
1
INSTRUCTIONS:
Form filad x
To be fiied in person w by mail with the CounryAUditor or Counry RemNer ot the county wheie the pioperty is IocateQ., L
Ffig Dates: 1) Real Property: Must file dunng the year for which the deduction is sought. J lJ , � 2
2) Mobde / Manufectured Homes iwt assessed as Real Pioperty: Must file dunng the fweNe (72) months
before Ma�ch 31 0( eacA year the deduction is sought. C, �
See reverse side 7a addtional instructions arM qua/dications.
Appyr�jrt(ownerorcmtraRbuyer-§eerestnr�onsmrerersesiie) GIBSON COUNTY AUD
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�i Iq. W�Id� 6 �15 � i12f BXdfi 5�13f8 0� Ill}CfCSI�
If n2me On rCaotd'a Qift¢rCnt Man Nat o( app&2nt, uiEipt¢ bCkw.
Name of rt�ortgagee n conaari
Address of rmtgagce w contre
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state,
3ssignee or other mmer w hdOer of rtqrtgage
>f ' ce(num6er ald spee(, cily; sbfe, eM ZIP co0e)
S
dimnt own poperty in any oNer I( yes, what count7/�
Indana?
❑ Yes ❑ No
20 _ � p--,� � n� 20
20
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RecoN rumDer
—00/ a0/�
Contratl mtlehtetln¢s imG� as d Ls M
Counry Auditor
County Recordu
ITOR
date of appOcation legal w equitade owrreYl
SO�O ❑Yes ❑No
IF awned wiN somearre dher Can spouse. hWiqte with whorn
h Me V� nY in 7uesbm: MnuaM Assessetl
eai amveM ❑ !�m�alry'.0.ssesud . . _
�-/. S �! �
VJhat Tarirg Distrir2? Has Na de�ur�m Geen requesteO m pioperty
fw aurent YeaR I—I Yas
❑ No
20 _
sg � or T a,cwr �� I camry
I
I I We certify under ihe penalry of �ury that Ne a e arM foregoing infortnation is W e and c
owner I conVacl buyer of the aforemenlioned pro on date application is filed.
Si9napye (u � na .
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r-rtiAl resitlem adtlress ol ap�rant (numDer antl sheet, state, and ZIP ootle)
ss�� sosH �as�Af.- ��,�o cs .,,, lN, Y���o
Pason aulMrtreE Oy tluy exeated Powe+of Attomey rn by IC 61. t-t2-0.7
AOtlress of autha'¢ed person (numDer a�M svee4 dry, sfale, arq ZIP cade) .
n,���,.�t.,vo.. aol3, .. . ..
Card !\'O. ... ��� p
15, � ..........
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