HomeMy WebLinkAboutMortgage_Brown (2).> "°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION �� g'�
S1ale Fortn 43709 (RS! 2-07) � �
�O � 1 Pr�aibed by Dapartmenl of Local Govemment Firence YJ
wsrnucnoNS: APR 3 2�� Mark
To be �led in persron or by mad with the CountyAuditor o/ the county where the property is located.
Fding Dates: 1J Real Property: Dunng the 72 months befwe June 17 0/ fhe year the deduction is to be eRective. _ �/��
2) Mo6ile Hartes assessed under IC 64.7-7: Behveen January 75 and Marcli 2 of fhe year the deduc�Yo�i'�6-to 6�j6if�rve.
See 2verse side (or a itional inshuctions arrd quali�cations. Q ��
( � � ,IBSON COUNTY AUDITOF
Applicant(owrrer '�}�e�e " a�m�verse`de)
of real propaly�s ¢ Alarch 1. anmt Y�� ��9a9e �
If r_ what is ha I her ezad share of inlerasl?
If rema m record is different than Ihal
Name of mortgagee or contrac�
mortgagee m oonUaa seller (number aiM s6eel. dty, state.
a Wier awner w hdder of marigage
Address of assi9�e (mmibei aM sGeet dty. stafe. and
Dces a�icanl wm property in anY olhr!
caunry m Indiana?
❑Yes ❑No
Dedudion apprwed in �he amoun� of:
1/Wec
Indiana
20
MJ• �'Y" W7 IR f}��� � IP9��
unpaid as of Marrh 1, Is Ihe app6pnt Ihe sde legal a equitade wm
san�eone
Wtal Taxing Di�
�1
couNrrnuoROR
❑Yes ❑ No
spouse, indicate wi�h wMm.
Is Ne propeM in question:
❑ R�I Property ❑ Moale Home QC 61.
' "W V -
d� 0�4-
�j�ct� 3o y/3, a�
20 I 20 _ � 20 _ I 20
20
g7i
rylwdilnr �.ounry uatel Va y� i rl 2 �J
�;—;�r•-
under penaity of perju at the above and fwegoing infortnation is Gue and correct and that Ihe applicanis was / were a resident of
iwner o the atoremenUOn roperty on March 1, 20
s M1il namel. . Date (month, daY. Y��
adent address of applirant ( mber and:
\� \� � �s
Pason auUwr¢ed by Auly execvled Power of Pl
a
persa� (numberarrdstreef,aty.state.arMZlPcode)
-� � l b b V
Dale (monN. day, yea�