HomeMy WebLinkAboutMortgage_Troutman'°* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_. ; FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R71 / 6-09)
�' yr P�ew�betl Cy OcpartrterLL of Lotal GovemmeM Finance .
wsrRUCnoNS:
F�� �n,:
b be filed in person w by mail with the CountyAuditor or Counry RecoNer of the counry whele fhe pmperty is lacat
Fd'ug Da[es: 1) Real Property: Must fila dunrg fhe year for whiUr Ihe deducfion is soughl. � � n ��ty,q�ditor
2) Mo6de / ManufecNred Homes not assessed as Real Properry: Must fiie dunng the hveAre (72) monMs �
6efae March 37 oT each year the deduction is swx�ht. ,LJ Counry Recorder
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See reverse sde !or additional inshuctinns and quelfiradons. (_/ J
MP� ( . armnvartbuyer-seqrqsMr��orrsonrerorsa�rcfa) . � GIBSON � �
ro.
tt name m remrtl's Ei.^.uent than tlut o( app�pnt uMinte helrnr.
Name of rtnrtgagea a mntract seller
Addtess ot rtnrrt)x)ee ar
aa s�er (numEef ane svee4 �1: state.
ner rn hdder of mortgage
antl snee4 �Y• stele..$^� LP ootle)
Docs a�imnt wm property in any oNer
munry in Intl�na? ❑ Yes
D2OuGDOn approved in Ihe amouM of.
�_
Sigriahue ot Cwr•.ryluM��.
�I / We certify under
ovmer / wntrad bu
k ��"a �
\ u0 � M a0tlmss of i
�_
It yes. whal
�
o a, -000. �55 - o 0
debtetl� unpaid as af Mortgape I Contraa i
� tlate ot app�ptim
R¢tnrd num0er Page numEel
aO�p 3S9S
impaiC a d h Ihe ePP�� tlu wk
Ie�i «MNrahle a.Tw1t
n Yes ❑ No
n ownee witl, san,erne aNm wn spaue. wkate
Is ihe property in puestion: MnuaOy Asw_ssed
❑ Real RnPertY ❑ Mnua�YAssessed
Mob�e Hartie (IC 6
i�-a -8 .v�i �
Wha� Tarin9 asUicl7 ' Has N's tleGUaion Oeen 29uested m P��Y
far wrteN Y�n � Yes ❑ �
COUNTY AUOROR ��
i
/ D,��,���►� �o.......olD.....
20 _ �
; C:]I'Cj l�i�. .. �......
�` 3 595
:nalty of perjury th�.the above arW foregoing infortnatlon
the afaeme�rooned property on date application is filed.
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it (rwmber anE stree4 �: state. end LP catle)
>, oqkl4.ol L.>4, r,v y?�<o
�teOPOwero�AnameYaM�� .,-,2-0.�
Address o( auttmrrzed ce� (numberarM sbeeG �ri state.
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