HomeMy WebLinkAboutMortgage_CornSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
ry+ FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R71 / 6-09)
�' � Fresatnea M Departmerit oi Locai covemmem Frtwrce
File Mark
INSTRUCTIONS: �QN
To 6e filed in person or by mail wiN the CountyAUditor or Counry Rernrder of the county where fhe property is lorated. O F ��:
Frtirg Dates: i) Real PropeAy: Must file durrng the }rear /or which the deductlon is soughG �+ � Coun Auditor
2) Mo6Ae / Manulactumd Homes not assessed as Real Property Musf file dunng the fweNe (12J maMXS h
6e/ore March 31 o/each year the deduction is srought. Cou^b Reco^du
SeereversesideforadditionalinstructbnsarMqualifications. GIBSONCOUN AUDITOR �
�.AVP��ll(owrieroroontraab✓Yer-seeiq�wicaorumrevgrsqf de) n
F�Y rnimEer / kgal d�aiGtion Rem�d rwmDer
alv-�.3-��- �too- oo�. 3 oo - oo �, �0�3
property as o( Mortgage / Contrarl'udebtetlness unpaid as of Mor�qage / ContrafY trWebtedness �mpaid as of Is N�
Mamh 1, W rtent�eer Eate of appllcation kgal
uhat is his / irer e�t share ot Inte
: m recortl a ddferen[ Wn that ot
of rtprtgagee ar mntratl se0er S
m m�trad se0er (n�m�6e� aM streef, ci(y. state. aM ZIP oode)
Name ot assignee w other awner or
mortgage
tl mmed with someone Uher than sPa�. udirale wflh wMm
;s�s8
�nt Ihe sole
iitade ameR
Yes ❑ No
Is tM property in puesGOn: Mnuaoy Assesse0
�"Real PropeM1y � MnuallyPsse55ed
_' __ � �_
Cv,e,v �3�� y �
�
J E�i � �
�.w,.._..�.. W_ ___, _,. __. _._ _.. _.._
S SE - a- ,9iAc app3-,%��8
own property in any oNer If ye5. whet muntyt What Tapng Dishid?
�� ❑ Yes ❑ No