HomeMy WebLinkAboutMortgage_Falls (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBT�F�S Coun 7ownship Year
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• FOR DEDUCTION FROM ASSESSED VALUATION g
� Slata Fortn 43709 (R71 / 6-09)
�' ,�,� � P�esaibeE by �epaNnenl ol Laal Governmen� Fnance
@ File Mark
INSTRUCTfONS: .JUN I p ZOI� F����_
To 6e filed in per5on w by mail with the CountyAuditor or Counfy Reoorder of fhe counry whe2 the propeRy is located.
Fiting Dates: i) Real PropeRy: Must file duriig the year for which the deductbn is soughL C. �. M�� �County AuEitor
2) Mo6de /Manulac2red Homes rrot assessed as Real Prt�peRy Must file dunng fhe lwehre (72 n
6efore March 37 0/ each year the deducfion is sought.
❑ County Recorder
GIBSON COUNTY AUDITOR
See reverse side for additional inshuctions arod qualfications.
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Page nyqio� l
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ContraG intlebtetlness unpaid as of I Martgage / Conbact "uWebtedness unpaid as of I Is Me eppGont tlu sde
irtent Y�/1_ _ tlate of aGP�� legal or eqtrila6le ame(1
If ranie m mmrd'rs Eitferertl Nan Nat of applkant, uMiUte 6ebw.
Name oi mortgagee ar mntract se�er
and stree4 �Y
w MNer of mwigage
(numberaM slreeL ctly. slafe, aM ZIP cade)
•r..'
Yes LI No
tl awned wiN sortieore ofher than spouu.
Is tM p�openy in Ques�on: Mnua�y Assessed
❑ Real RoPertY ❑ %�^^�Y%��
MoW7e Home fIC 6
IOces applinnt oxn ryoperry in any oNer I IF yas, whal munt�? I VJhat Tad�g Disvia? I Has Na CeNiUion been requestcM on proprny�
munry in InOeria? ❑ Yes ❑ No fw wrreN Y�n � Yes ❑ No