HomeMy WebLinkAboutMortgage_Wellmeyer"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
:� — :
. FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709 (R11 / 609)
�,�,� � PresaiGetl by �eVa�M of Local GovemmeM Fwxa
�STRUCTIONS:
be filed in person a by mail with the CounryAuditw or Counry Recorder o/ the counry where tAe pmperty is located.
Fitirg Da[es: 7J Real Property: Must !le dunrg the year for which the deduction is sought.
2) Mobde / ManWactured Hanes not assessed as Real Pmperty: Musf file dunng the tweNe (12) months
before Ma�ch 31 of each year Me deduction is sought.
See reverse side t�adU'tional instructions and qualifications.
APP6nm (owxr trart buyer- see resnicnwy� on revarse side) � . /1 n
Key num0er / l^egal desc
. � 1 � N O ^
Asse� rdlue of rnal Fvoperty
M2�M 1, ameni yPar
iw�
nartre m rcmrE is dilferent Nan ihat of aDP���• �dinte Gebw.
Name oi mortgagee ar conUact selter
Address of mortgagee w contrad
Name of assi�ee or oihaJ owner
stme4 �:5 _'.. -.`�= �_'
Oces applimm own property in any aher
�,� �� im�a
❑ Yes
Dr�ucbrn aGWO+� m �he amount of:
zo� �
i —
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Co�uditor
County Recorder
GIBSON COUNTY AUDITO
RecoN number Page numbrr
someo� oNer than spouu. intlitate with whom
Di•a�►�e►• Np.,a���
....; ...
t
CaCd NO. ....r'�. 7� � -
........�....
�7�,a� ��°
: appfxant Ne sde
or equiFable owm`l?
❑ Yes ❑ No
Is Me prope�ty in questian: MnuaDy Assesstd
i,] Real Property Q MnuallyAssessed
detludion Eeen
u yea/?
�_
��,�.�Y,��
� v�r
❑ No
�
I/ We certify under the penalty of perjury that the above antl foregoing infwrtiatim is We and cortect arM ihat the applirant is a resideni of Indiana aM
er / mntracx buyer of ihe afaementioned property on date applicalion is filed.
� (mvners mm �arrre) / . ., oate (rnorm�, dar. r��
W Attamey w by IC 61.
persni (numbera�M sneet ury. sbre,