HomeMy WebLinkAboutMortgage_Brown (9)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ s FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R71 / 6-09)
�' � Presai6etl by Department oi Lmal Govemmenl Frence
INSTRUCTIONS:
To be frled in person or by mail with the CountyAuditor or Counry Recorde� oI Ne counry where the property is located.
Filing Dafes: 1) Real PropeRy: Must file dunrg Ne year fir vrhich Ne deducLOn is soughG N,
2) Mo6ile / Manulactured Homes nof assessed as Real Praperly Musf file during the hveNe (72) months
6e/ore March 31 of each year the deductivn is sought.
See reverse side for additional instroctions and qualfications.
� ��\/Y 1���/ n �seer�wir�smre, ve�sile) n�. i`1 1 GIBSON
/ �' lJ�
m
m morcgayee «convaa sener
s W rtnrtqaQee w mntrad sWer
Name a1 assignee w
own property in any oNer
a� ❑ Yes
Dtauction approveC in Ihe amouM oF:
i - .� �
/ Contract intlebtetlness unpaid as of Ma
a�rtent year daL
If owned wiN
Oeb�r
�
cify, state, aM ZIP code)
slate, and [�r cooe)
If yes. what county7
I No
4Mat Tad(g Distriri?
0
� g9���d,�.
County Recorder
[1�J .� / U
hceC�s unDaid as d Is Ne appfirant the sale
legal w equilade rnmeR
� � ❑ Yes ❑ No
spouse. Indrcate with whom
Is Ihe propeny in a�g�: �+^nua%ASSessed
❑ Real Roperty ❑ Armualh/ Psses;ed . . _
.o...���•.....
DT�\YCT � ��0�
CaTd�O• ......�•�'�.d°�
�
20 _ 20 _ 20 _ 20 _ 20 _ _ 20 _
Inature of Counb AudN,or Counry Date (mw�N. OaY. Yea�
I/ We cerUfy under Ne penalry of perjury that Ne above and foregoing intortnalion is we and cortect arW that Ne applicant is a resident o! Indiana arW
owner I contraa buyer of Ne aforementioned property on date application is filed.
irewre towneYs Iu0 nau+al Date (rtwifh, daY. Y��)
resitlent adEr�s of a0o�nt (number anC
Person autiio�rzetl by duy ezecutetl Power ol Attwney or Oy IC G7.
Pdtlress ot au0�a'ved person ( number arM sheet, riry, state, and Z