HomeMy WebLinkAboutMortgage_Adams"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Courc
__ ; FOR DEDUCTION FROM ASSESSED VALUATION
$Iate FOrtn C3709 (R71 / 609)
,,�,� � PresQibed by DePe�N of Lod Gavemment Finance '
INSTRUCTIONS:
To 6e lled in person w by mail with the CounryAuditor or Counry Recorder of the counry where fhe p�opeM ls bcated.
Fitirg Dates: i) Real PropeRy: Mus! fite dunrrg Ne year fur which fhe tleduction is soughL =
2) Mob�7e / ManuFactured Homes not assessed as Real PropeRy Must file dunng the fwelve (72) months
6etae March 37 0/ each year Ne deducGOn is sought.
See reverse side for additional instnrctions arM qualifications.
AooG�-enl (owneru cont+aU bWeri-me rc5t��s m reyxrse sidel
�scsuE ra4ie of real ryoputY a o7 e/ Gont
emh 1. tl�mrt year Ma � I
E
ro, what ts his / hu erxt snara of intereu?
nartre on recoN is tlilterent Nan Nat af aPP�^L InEipte Debw
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nddress m �mogaqee or m,o-aa
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Dces epplifant own poperty in any oUer
munry in Ind'a`u7 ❑ Ye5
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ary, slate, and Z/P mCeJ
File
R � �Nt1a,e�m�
❑ Counry Recorder
GIBSON COUNTY AUOITOR
- 6oD • � 5-0� �'ai o P� S 3
eMeEness unpaid as o( Moriga9e / Can:ra7'viEehtedness unpaN as d Is Ne appfxant Ihe mla
� datc of app&ation kgal a equibde ovmeR
❑ Yes ❑ No
If awned with sameme dhar Can soouu. iMi�ate wiN wMm
It yes, whal munt�? � What TarimJ DiStrict i
I Is 4�e P�P�Y m 0�%�+: MnueOy ASSesSed
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Card \O. ... °20�� .
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IHas this deduCion Daen (epuested m property
���� ❑ Yes ❑ No