HomeMy WebLinkAboutMortgage_Pfingston^'� STATEMENT OF MORTGAGE OR CONTRACT I E� oun Township Year
_ : FOR DEDUCTION FROM ASSESSED VALUATI
� � �• State Fwm C3709 (R71 / 6O9) .
•4' ,u. l PresaibeO Ey Departrtrenl oi Local Gavemmenl France
�sTRUCnoNS:
��T � Z��� FileMark
o be ned in rson or b maii wifh the Coun Auditw or Coun Reoorder ol the coun wh F� �� ��
PQ Y �v N N � RY is focated.
Fi7irq Dates: 7) Real Property Mus7 �Ie dunng fhe year Por whicA (he deduction is soughY' � Counry Audimr
2) Atobile / Manufactured Homes not essessed as Real Property Must file dunng tha e months
before March 37 of each year the deduction is saght. ❑ Counry Reoordw
GIBSON COUNTY AUDITOR
See 2verse siQe for addilwnal instrucfions and qval�cat'ans.
nt wrrerw�trdrl6uyer-se re mreverse�s' ��
�Y
Ir no. what Is his / her eraC
If name pt remfd is
Name at rtnrtgagee or contract seqer
Delow
numbu
� _� _ _
unpaiE az W Mwtgage / Cono-act "vWebied�ss unpaiE as d Is � e eppfimnt �e sde
Aate of aOP��m� legal w epuitade owneR
❑ Yes ❑ No
H ovmed wiN someone ather ihan spouse. ind�te with wMm
cantrad seAU (nan6rl end snee4 �1: �+e. eM ZIP code)
Aaaress oi assignee
Dces applimnt own poperry in any oNc
counry ip Indiana? ❑ Y25
\
20 I 20
u of mortgage
crty, slate. end LP codeJ
u res..�mat couory.m
❑ No
�„ COU
20 20
is u,e wovartr �� n�esa�: r�o�any a�sea
�2ea� Proprlty ❑ tvmuanyAssessed
_ prativec• �\'0.... �,��99...
�, Card NO. .....�.1,�3 .�,P�m
s ❑ No
���nrrno ��l��J'� •••,
�v
p— I p I p
I/ We certify under the penalty of perjury that the above arW foregoing infwmalion is We and cortect arW that the appiiqnt is a resident of IrMiana arW
owner / contracl buyer of the aforemerrtioned property on date applintion is filed.
�na4ue�{e�ne/s fiAl reme) � A ' _ Date (month. daY. Yme�
state,
���1� ' �
ot Avaney or by IC 61.
autfrarzed person (numbelaMStreet, ary, sfate,
Date (monlh. daY. Yaa�