HomeMy WebLinkAboutMortgage_Finney^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun'
___ . FOR DEDUCTION FROM ASSESSED VALUATION
• Sfate Farm 43709 (R11 I 6-09)
�' PresaibeC M OeP��N of Lacal CovemrtreN Frwca
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�STRUCTIONS:
To be filed in person w by mail witA the CountyAuditw or Counry Recorder o! ihe counry where the property is located.
Filirg Dates: 1) Real Property: Must �Je dunrg fhe year lor which fhe deduction is sough[.
2) Mo6de / Manulactured Homes not assessed as Real Property Must h7e dunng tha tweNe (72) months
before Ma�ch 37 o/each yearthe deduction is sought.
See teverse side (or adUitional instnations and qualilcafions. �
T p Oistri Key fwm / le al tle�dipti
nss�ssea � a rea� a�a�r � a nart i co�o
n�a, �. a,rem rm � M
Ii rm. what fs his / her ezaG share of interesl?
If name on remd is Q�Ifemnt Nan �hat of aPW���. 6M'vate celmr.
Name of mMgagee ar mntracl sWer
nearess or moro�ayee «m,o-aa uner
Name o1 assignee or oMU owner or hol
Mdress oi asvgnae (number a�M slree
property in any oNer
❑ Yes
Deductirn aDF�� u� tlre amount
sfate,
�
�ry Auditor
��ry Re[order
GIBSON COUNTY AU
RecoN n�mDer P:
�itade owrtie(?
Yes ❑ No
Is Uie AoG�'rtY m 7uestion: Mmu�Y AtisesSeA
❑RealRoperty ❑lvmualyAssessed
mortgage —
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slate,andZ/Pcode) . _/ol\......•••
� J�
ur�.�« pl':l\\'Cl \�... .
No �� W. �• • . . . . . .
Cati(110• .....
duqion been reduestetl on proprlty
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20 _ 20 _ 20 eu 20 _ 20 20 _
Sigiatlrte d CamH Auditor Counry Da�e (month, OaY. Y��
I/ We certrfy under Ne penalry of perjury that Ne above arW foregoing informatlon is We antl correct arW that the applinnt is a resident o( Indiana and
owner/ contracl buyer of the afwementioned property on date applirabon is filed.
it add�e5s d applrcani (numDerand stiee(, cify, state,� ZIP cd
wraed by Cuty ezecuted Paxer af A¢omey m by IC 61.1-12-0.7
authortred Person (numDer aM strcef. ritl: sble. and LPmde)
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