HomeMy WebLinkAboutMortgage_Allen (5)�
^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ _= FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R71 / 6-09)
� � Presaibad by DepartrnM of Lacal Govemmenl Fvarce
�.nn
INSTRUCTIONS:
To be filed in person w by mail with the CountyAUditor or Counry Recortier o� Ne county where the pmperty is F��1 �� ��
Fifing Dates: 1) Real Property Must fde durirg the yrearlor whicA the deduction is sought �B 2 L�, County Audimr
2J Mobde / Manufactured Homes not asseaed as Real Property Mutt file dunng the nvelve (72) months
6etore March 31 o/each year the deduction is sought. C,'�, Counry Recorder
See reverse side for addrtional inshuctions and qualifications. �
Ap (awnerorcontraCbuyer-see� mreverseside�)y� ) /J �/��� GIBSON CO
`7I . � l!"(3/Yf�.l. //� ���.XXF��
ard� 7, a+mrt ym
ara
ro. wttal 13 NS / her e� sltare Of Ntei
�ame m remrd'¢ Oifrerent Ilw� Na� of
r/ legal desc�iption ' RecorA �w Page number
��D'- 6-Y�.3-OoO. y3�-ooP d,�! y3
MoNlage / Contrau 4drbted�s unpaid as W Mortgage I Con�act m0ebtetlness unpaiC as of Is Ne epptiont Na sde
Maz� t, a��{+� date of apprmalnn legal or equiiahle vHndt
`7 � a.lJ n ❑ ves ❑ No
mEi�ate
matg2gee or Contract Seller �� I 1�/ r�\,
H , �_, ,
�.. �_.,._
ot rtwrtgagee v mntraa se0rs (nwnber aM stree4 u6:
Name of assi�ee w ottmi owner or
AearPSS ot
Yes
Ordu�rion a7W� u� 1he amount
20 _ � 20
mortgape
state, aM
i
No
n someone otn� inan spouse. masate w+m �
� y � �� ,��
����
� a0/ I = �3
I( yes, v
20 _
' i _�._, .
(�
� - � , r.� �
� I/ We certify under the penalry of perj Nat Ne above foregoing infortnaUOn is We end mrtec[ arW that ihe applinnt is a resident of IrMiana aM
owner I wntract buyer ot the afaeme � ed property ate application is filed.
s�8tan,re neme) '� oate GrvNn. aar, n
I �til,c �j � o�- 07� / /
Full �esE ed W a t(numDe�and (�}; state. and LP code) �/^� �
S 1%2.c a yds ��i�/ �` �
Persnn au4�w'¢e0 Dy dury rxewted Puwer of Aitomey w by IC 61.1-12-0.7 Wte (rt»nN. day, yee�
aNhot'vtd person (num6er aM 51�ee; cily, stato, end ZIP code)