HomeMy WebLinkAboutMortgage_Gonzales"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_, , FOR DEDUCTION FROM ASSESSED VALUATION
_ Stata Fortn 43709 (R71 / 6-09)
�' w. Resaibetl by DepaNrerd of L.oml Gavemmcrit Firence
INS7RUCTIONS:
To be filed in person or 6y mail with Ne CountyAuditor or Counry Rewrde� o/ Ne owmry where the pmperty is located.
Fifing Dates: 7) Real Property: Must file dunng fhe }rear fir whicA the deduclion is sought
2J Afobde /Manufactumd Homes rrot assessed as Real Property: Must file dunng tAe tweNe (f 2J monNs
be(ore March 37 0/ each year Ne deduction is srnght.
See reversa side for addifional inslrwctions and qualifications.
Appfxant(owrrermmntraU6+A'er- onreyersesiCe)
2 c2���ua��
Caunry Recorder
GIBSON Gvu� � •
�' Distria Key �wwmber tlesaiDrirn RecorE numCer Pa9e number
- �3 -a!o - `��o -eoo. 3 aY-oo ,6 ao 9/(
Assessed vahie d real poper:y as ot M�q� ge / ContraR Inde6teCMSS unpaid az d Mwigage I Contrars iMebtedness unpaitl as of k Ne �plkant the sde
MaU 1. artent I� Memh 1. a�rten[ Y� datc W aPP�� legal or eWitahle oxrrell
� [� ❑ Yes ❑ No
rc m. what 6 ha / hu esact share at interest? It ownetl wfth sortwrone dher ihan spouse. itd'vate with wtwm
If rwne m remd is QAlvmni Wn Nat W aDP��• trM'uate bebw.
Name ot rtmrtgagee ar contrar3 seDer �/�
AOdress d �mt�ag� w contrad seDer (n � end sb
Name o( assignee or othu owner w hd0er of mor[gage
state. arM LP code)
AilCress of as9gnea ( mber artl S f, ay, state, and LP code)
E SF -a-9 3.35 �{G
Dces eppFCam own pmperty in any ahu 1f yes. what count�? VJ�at Ta�dfg Disv'ri?
munry in Indiana?
❑ Yes ❑ No
COUNTYAUDROR
zo � zo _ � zo _ � zo _
Counry
i I We certfy und�f �he penalty of perjury tF(�t ihe above and foregoing information is W e.
owner / contracl buyer ot ihe /atorementimed property on date apqication is filed.
'i �"'��rt ,"f
msident addfes rof appGmnt (numDer arN snee4 �1: �1e. an/d/ZfP1cotle) r/
��%y0��0 4• �/,SO r7i �%t�!�Gh(tli/"/✓ �/" �%�(PC
rxn authoraed Ey duty �ew�etl Pwer of Attornay a Oy IC 61.1-1 .7
M aW�or'ved persan (n�mbererW sase( ciry, sbfe,
Is Ihe m Ouestion: MnuaDy Assessed
eal P(oPertY ❑ !u�n!�all�' �
en requested m property
❑ Yes ❑ No
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