HomeMy WebLinkAboutMortgage_Oneal (2)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ns
FOR DEDUCTION FROM ASSESSED VALUATION
Stata Farm 43709 (R70 /N-08)
� f PiewibedbyDePa�trnen�a(LaalGovemmardfinar�
rNSraucnoNS: ���JM��$ 2009
To be filed in persan ar by mad with Ne CountyAudilor d the oounty where the properly is lacated.
Filiry Oates: 7) Real Property: Must file dunng fhe yee� lor which the deduction is sought.
2) Mobils / Man�lactured Homes not assessed as Real Property: Must fde dunrg tlre fweNe (72J monfhs 6efore �R78rj�63� ��ar
the deduction is sought. U
See ieverse side faraodAional instrudions and qualrfications. GIBSON COUNTY AUDITOR
Appfrant (ownor or mrtLact divor- see msbiCions m mwrmcniel .
Key mimeer � leqa� ee
�f �af�-
��
� n
� �
C�
20 n 20 20
" l �d^ L
iMnNMnn4c �w�,tid az
20
MMaane
�
legal
i sVa+se, indirate with whnn
Nis
20
oylre!!
❑ No
Question: AnnuaM ��ssed
N Q Mnuauynssessee
baen �aauested on P�GaM
❑ Y25 �'
20
1/ We certify untler Ihe penalry of perjury ihat the above and foregoing uifartnation is We and carrer2 and that Ne app!'irant is a resiAent of Intlia� and
awner / contrad buyer o( Ihe afo�ementioned property on date apptiption is hled.
♦efJ n �
aulhwizeE by du/y exewted Po-wer of Aqomey
IC 64.1
person lnimMrantlst�mt,tlty,smfo,
Oate (monfh, tlay, yoar)