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.�+°•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Township Year
- FOR DEDUCTION FROM ASSESSED VALUATION
s�a�e Fom, aa�os �as i z-0»
S � Preso3ed by Department of Local Govemmen� Firence �
ar
JUL �e1M�@�8
�NSrnucnoNS:
To be (led in person or by mad wdh Me CountyAuditor o7 the county where fhe propedy is located.
Fding Dates: 1) Real Properfy: Dunng the 72 months before June 77 of the year the deduction is to be eflettive. `�/'yJ
2) Mobde Homes assessed under IC 6-7.7-7_ Behveen January 15 and March 2 0( the year the deduc6on is fSbe e ve�
See reverse side la addfional insWctions arM qualifications. GIBSON COUNTY AUDITOR
(Nwnerd%YL�/�0�.✓/�3 S��l.�VtIJGQ�/,l��Z�'1'L�-�GJ
ric4 Key num6er I legal tlescription • Recortl num F' e mimber
- � a��-i -3 S -3oa-oo�. ,3 � y - vo6 �loO
alue ot real property as d Mafch 7. anenl year Mw�gage / Contrap ude6tedr�ess unpaid as of March 1. Is U�e applipnt Ihe sole legal w equita6le owne �
wrtent year
- �. . ❑Yes ❑No
is his / het rxffi share af interesl? ' If owned wilh mmaone dher Utan spouu, indifate wilh whom.
If reme m recwtl is tlil
Name af mor�qagee or
of mortgagee w mnUacl seller (number aM :
Name ur assigriee «aner owrrer or naa
Address of assgnee (number arM sheet.
Does applican� wvn poparty in erry o�her
tounry in Inda�?
❑ Yes ❑ No
below � ,
m� Drawer i\'O..PZQQ�. _
s(ale. � , i �� ! 1: . 'I. ... ..
Card i\'O. . �a0y.. �r ;,_
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Is �he property in question:
❑ Real Pmperty ❑ Modle Hane
Mas Ihis detludim been requested on poperry
for arrenl yea(?
❑ Yes ❑ No