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HomeMy WebLinkAboutMortgage_Junkman"^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS o s p Year __.. = FOR DEDUCTION FROM ASSESSED VALUATION • State Fartn a3709 (R71 / 6-09) �,.,� j Presaibed by Deparimertl of Loml Govemrtrenl Finarce �t� 1 �NSrnucnoNS: F� �aea w�m: To be filed in person w by mail wifh the CountyAUdROr or Counry Recorder ol Ne county where the pmperty is located� � v Rfig Dates: 1J Real Property Must file durrrg the year for whicA Ne deduction is sought !�����n 2) Mobile / Manufactured Homes rrot assessed as Real Property.� Must fiie dunng the hvelve (72) monfhs v netoreMarch3lo/eacnyearthededucrionissouy . GIBSONC NI�Y�A�1 See reverse side fw zddilio instrtictions arM qualifications. ` _. t App&ant (ow�e; mnvacf b see resvirlions m re �erse,Zde) n Auditor �- � -� � �� v �� ssed vdue of real poperty az of Abngage / Conbact'udeb�etlness unpaitl az of Mortgage / Contract mdebtedrress unpaid as of Is Ne epp6rant the sole i 1, arrera year March 1, arteM year dare N appGption legal w equRade owneR � Yes ❑ No what is his / her exatl share o( intemi? If oxmed wiih someorre dher tlan spaise, irdpate with vAfom tl name m fecwd is dAtvent than that o! aPP��t indinte Eeb�r. Name of mortpappe yr mnVact seller mortgage (num0er ered atree4 �Y. �le. and Z/P code) Dces epplimm own property in any oNer I IF yrs. what counry? munry in Indiana? ❑ Y� ❑ No COU ••_•...-•,_, +...,�.�.+d In tlre artwnt of. �,-1,����-.io....aG4�..... — 2o Is Ihe property in puestiwi: Mnue�y Pssessed �$eal Property ❑ MnuaOy Assessed DistriGt? Has Na tle� far current y �� � � P�W�'+b ❑ No �_ C� 5 3 I ��ry ���,�. �Y �� c���a ��o . ..................... 1 I , �{C'� OD ve and (oregoing in(ortnatlon is We and mrrect arW that the applicant is a resident of IrMiana arM LY� y on da[e application is filed. � v.v�.w. resident aCtlt�s of r \ �� `�1 statB, 3M ZIP c�tle) w�c`..r�, LN y1�`�`� oy ic �,. �� c��, P.dtlress of autlmr'vEd person (num0er aiM sbeef. cily, sble. and ZIP cnde) . I �