HomeMy WebLinkAboutMortgage_Young"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tawnship Year
__ = FOR DEDUCTION FROM ASSESSED VALUATIO�I—� ��
� State Fortn 93709 (R71 / 6-09) �p'�
�' y„ � PresQiGetl by �eflartmerd of Lxal Govemment Fi�ams Y
File Mark
NsrnucnoNS: NOV 4 2�11
k be filed in person or by mail with Ne CounryAUditor or Counry Recorder of the counry wl�e`e the property is located.
Fi/irg Dates: 1) Real Property: Must !le dunng the year /or which the deducfion is sought. ^
2) MobBe / Manulactured Homes not assessed as Real Property: Must fJe du�hq'O�e e 12 nths
6e/oie Ma�ch 31 of eacli year the deduclion is soughG
Seereversesideloradditionalinsfrycfionsandquali�catans. GIBSONCOUNTYAUDITOR
ADP�n� (owner orconuact b � . m reverse sde) / .. .
{i Y
etl raWe d real poperty as ot
1, qprent yr1�
—a'Ul-
Vat N aPP����. ��te Gebvr.
r7ame a nnrtg��re o. m,eae sener
Nartre of assgnee
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qd/ .
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ee n rvnbarl sr7'
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20 _
i/ We certify under th�e penalry of �erjury that Ne
owner I mntract buyer of Ne a(oremenboned pro
ffi�.
.,,etounty?
Fortn fded with:
� CounryAuditor
❑ County Recorder
7_!.�^ / I Retord numbPl I Paye
v�� � �
someone other Ihan spouse. mdirate with wMm
Whal Taring DistriG?
� 20 _ 20
CaurHy ^'
a and foregoing infomiatim is we and
�e date appluation is filed.
autM�¢ed by EWy esewted Power of Attorney rn Cy IC 61.1-72-0.7
3 0( auttmfvEd person (numbera�M snee4 ary. sbte, and ZIP code)
rant Ihe sole
iitade rnmelt
Yes ❑ No
Is tl�e GroPertY in 9uesGOn: MnuaOy Assessed
❑ Real ProPenY � ?!��!��Y �
�
Dale (monfi, OaY Y��)
� P�Y
❑ No
�
correct antl that ihe applinn[ is a resideni of IrWiana and
Date (nmfA. daY ysa�
Date fmonN. tlaY N��