HomeMy WebLinkAboutMortgage_Fischer^�� STATEMENT OF MORTGAGE OR
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� FOR DEDUCTION FROM ASSES�
• SlateWtm93709IR11/6�09)
�' ! Presaibed by �epartment of LoCal Govemment Fnenq_
�srRUCnoNS: APR 2 7 2012
To 6e �led in person w by mail wiN the CouniyAuditor or Counry Recorder o/ fhe county �er�e ro�rty is located.
Fifing Dates: 7J Real Properry: Must file dunrg the year for which fhe deducLOn is�oi�Al.
2) Mobde / Manulactured Hanes rrot assessed as Real Properly Must ne dunng !w� (12) monfhs
beforeMarch37o/eachyearthededucfionissought. GIBSONCOUNTYAUDITOR
See reverse side fo� ad�nal instrucGOns and qual"�ications.
MP�m (owner a ,� �n r�yver�e side) (� � ^ . .... n . /�
File Mark
Fartn fle0 wiM:
Counry Auditor
Counry Recorder
Ta D' � Key ruuny�r'/ iegal desaiplion � � ' Remrd numEe� P e nup�r
o�l0-(3-/3-S�dd-C»0_alL'� l�" �I
raLe d real �aape ,ry of Mo�(qage /(',ontraa "uWebtetlness unpaid as of Mortqaqe / Con:raU "uWebteEriess �mpaitl a d b Ue ap the sde
Martl� t. cumR ymr Mamh 1, wrtmt �CD� date o( aPP��� legal O'�e wm�
J ❑ No
If ro. wha� Is his / trer ern] shara o1 inteie5ll If a�med wiN someone dher ttun spouse. indkate wtrh �imm
If name on recortl a dMerenl than that of aPP�n4 ifMip[e bebw: I5 Ihe P�PeM in Question: MnueOY Assessed
❑ RCaI Pfoperty ❑ %vmU20y AssesSed
I 0.bdle Fbme (IC 61.1=�
Name W rtiartgagee or contrarl
w cantract sr�� (nuMer eM sbee4 �j. stafe. erN ZIP mde)
w oNer owner w halder of mwtgage
AAdress of assn7rree (num6erard sbeeL �Y. state. antl ZIP cotlel. _-" —
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Do�
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— ' . ,. C�l'(i.��. .. •�y�i�.OQ
sg�wre
I/ We ceNfy under the penslry of perjurj� that the ahove� fore
owner I contract buyer of �he aforementioned property o [e a�
SignaW ovmers fiAI name •
So � .,�,a�. �s . � � J
FWI rnsi ent addres of appfmant (number antl sbee4 a7: �le.�g I�P m[
o//7 5����vE OaK�a,��! �: i
Pr�son auttp�d Gy dWy ezenrteC Pawer of Attomey or by IC G7.1-12-0.7,
ACGress of aWwr'ved persan (numberaM s�eeef, dry; state. an0 ZIP cade)
W�at Taring D'str'v3?
COUNTVAUDROR
zo 20 _
�ur �
Has Nis deduGion Deen repuesiM m ploperty
ro� w�� r�r r-i .,_ _ r-i
� I p—
infortnation is W e and mrtec[ and that Ne applicant is a resident of InEiana ard
ion is filed.
bate (month. daY, yve�
�_ ��-i?
Date (monN. Aa): Yaar)