HomeMy WebLinkAboutMortgage_Wethington (5)I
�
.e.�"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Year
�,, ., ? FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fortn 43709 (R8 / Nl7) M R 2� L��9
���; '' Presrnbed by DeOartmenl of Local Govemment Finance
INSTRUCTIONS: O'1��� ��
To be (!ed in person or by mail wifh the County Auditor o7 tAe tounty where Ne p/operty is located. � V
Filing Dates: 1) Real Property: During the 72 months belore June 77 of the year fhe deduction is to be effec6va. GIBSON COUNTY AUDITOR .
2) Mobile Homes assessed under IC 64.1-7: Befween January 75 and March 2 0/ the year the deduction is to be eflective.
Sea 2verse side la additional instiucfions arM qualificafbns.
nl (owner w mnlraq bvyer - see resficfions on reverse side)� . -
d `'i ��t:
DisVia K numbai/legaltlesaipibn
�- - -.3OC7- �o/• O S/- 00 �
ed vdue of real popaty as of March 1, anerrt ymr Mwlgaga / ConUaa intleWedness unpaid as of March 1,
nirtentyear / � .
�
�hat is his / her exact share M interest? If ed with wrt�.rone oU
If name on record is ditterenl ihan Nat of applicanl, indipte below:
Name of mahgagee or conUact seller ^ n , � J—
%}..fN
Address of rtqrlgagce a wnf+aci seller (number aM �reef, tiy, 5ate, aiM ZIP code)
Name of assignee or oiher ow�r or hdder of matgaga
AOtlress of assignee (n�mber aM s(iaet, city, 5ete, and ZlP oo0e)
Does applicant own property in any other If yes, whffi county?
ca,mr � i�c�a�aa
❑ Yes ❑ No
��-- i����� � Z°-
Remrd number Page number
i ��R �o ��
Is ihe appGmnl lhe sda legal a equitada ameR
❑Yes ❑ No
er than spouu. indicate with whom.
Is ihe propaM1y in 9uesUon:
❑ Real Property ❑ Mobile Home QC &1.1-7)
J �
'�R-19g1
wne, Te�;�a ou /� a 0+r
aQQq.::..:.... ,
�1��A`Cl ��' -
COUNTYAUDROR
��,d��• ��4�.•�'U(v. ao -
20 2� p,� K3 _' I 2�_
i re ot Counry fwditor �/% /—'/ I Courrty I �ate (mmfh. tlaY• Y��
��i l' � �
I I We certiy u er lhe penalty oi perjury t Ne above and faegoing infortnaCOn is We and cortect and Mat tlie appli�ants wes / were a residenl of
Indiana and o er of Me aforemenGOn roperty on March 1, 20 .
�. (owner I name) /� � i Date (manN, tlay, yea�
I���� //
o,, dF
vdenl atltlress ot applicanl (num6er and streel. c' stete. and ZIP mde) ,
,,..�.-. n i,� � r^ � .-._... .i-�,i.in ..
Person aulhonze0 by duty exeated Power ot Plinmey or by
Address of aullur¢ed persm
aM