HomeMy WebLinkAboutMortgage_Fetcher (2)_"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ = FOR DEDUCTION FROM ASSESSED VALUATION
• State Fom193709 (R77 / 6O9)
�' ,.,� ? Premibed by Departmenl of Lo�l Govemment Fu�ance
INSTRUCTIONS:
To be fi/ed in person a by mail wifh the CountyAUditor or Counry RecoNer o7 the counry where the property is located.
FiNrg Dates: 7) Real Pmperty: Musf file durirg the year (or which the detluction is sougA(.
2) Mobi/e / Manufactured Homes rrot assessed as Real Property Must file dunng [he fweNe (72) months
before MarcA 31 0/ each year the deduction rs snught.
See ieverse side !or additional instnictrons and quali�cafions.
IAOOfirantlonneraconhaCDuu.R-seerasYi�onsmrevemesidel �-. / i .
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1. anent rear
0
:/ Contraa ind�tedn¢s unpaid a ot
Wrrent yP.ar
Name of rnortga9ee or contract seller /7� Q, ^
/ ° �f l�/
l.. JV ��_�
Addtess of matga9ee ar mntrsU se0er (nurs�ber aM svaet, clly. sfa�. arM ZfP code)
Name of assignee or otha owner or hdder ot'mrtgage
N�l ��'�2���
County Remrder
GIBSON
- O� �f' ����
a9e / Contraa hdebtedrress unCaid as d
r ev rJf �J . �'�
auoiTOa
Is Ne epplxant Ne sde
legal w equitable avneR
❑ Yes ❑ No
someone other ttian spouse. ud'xate with whom
pmperty in puesEm: MnuaOy Assessetl
al RoPeAY ❑ ArmuallyAsse55ed
Mahile Harne fIC 6
Hvarass o� asvjriee lnumuer anu vreet �Y, �e. nru �
� /9- �- 9 . ����
Dces e�imnt wm ryoperty in any Whu 1( yes. whal munry/.� VJhat Tarirg DistriG7 Has IhiS detludion Deen requested m properiy
munry in ind'vra? ❑ Ye5 ❑ No (or wrtent yeaR � Yes ❑ No