HomeMy WebLinkAboutMortgage_Green^�� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
__. _ FOR DEDUCTION FROM ASSESSED VALUATI�!{ ���
� State Fortn 43709 (R11 / 6-09) �■-�
�' ,,,, Presaibetl by DepartrneM o( Laml Govemment Frence Y
Coun Township Year
File Mark
�vsrRUCnoNS: �(j �A �0��
Sro 6e ned in person w 6y mail with the CounryAuditor or Counry Recorder of the couny JJHe �e p perty is located.
Fil'mg Dates: 1) Real Pmperty Musf file during the year /or which the deduction is soughs.
2J Mo6ile /Manufactured Homes rrot assessed as Real Property Must file�du " 12) months
6efo�e March 37 ot each year the deduclion is sought.
See2versesideforadditgt(�alinsWCtionsandqualifications. GIBSONCOUNTYAUDITOR
AppGwm (ow�r ar
Fam filed with:
� Counry Auditor
❑ Counry Recorder
i q Key fwm / IegalOescrip' Record n Page
� w o� �0--13- � 4`d90 -Ub0• I 9 7-oio(o � `�'�`3.(�
1 va4re cf rnal property as of Mortgage / Contraa ir�ebtednass unpaid as of Mortgage / ConvaU bWebteOness unpad as d Is Ne eppGant Me sole
mrent Y� / Mamh 1. a�rtent YeK�/��O V` J Oate ot avditation �� ❑ Yese ❑ oN
exac2
If name on recoN is EiRe�ent N2n tlfa� Ot app6canL'ofdiC2t¢ 6¢low:
Name of mortc,�jee
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pE�, Nss �
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•, aM ZIP code)
sPOUSe, iMicate vriih �Nnm
Is ihe property in O��m^: �nua0y ASSesuO
❑ Real Roperty ❑ MnualiyAsse55ed
Mo67e Hane fIC 6
' 1`�' �� .�, wunryR NRut Ta�d�g DisUia7 Nas Ihis deEUCTion Deen reQUes�eO m D�Y
I _...� LJ No I � wrt� � ❑ Yes ❑ No