HomeMy WebLinkAboutMortgage_Naas"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun'.
_. FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R71 / 6-09)
� � Presaibe0 M��M of Local GovemmerG Financa '
w.
wsrnucnoNS:
To be filed in person or by mail with the CountyAuditor or Counry Recorder of fhe county whe2 the property is located.
FiNrg Dates: 7J Real Property: Must fi/e during fhe year (or which tha deduction is wught.
2) Mo6i7e / Manufadu/ed Homes nof assessed as Real Prtiperty: Must file dunrg the tweNe (72J months
6e/ore March 31 oleacA yearNe deduction is sought.
See reverse side tor ad ilional instructions and qualifications.
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❑ Counry RemNer
I^P�°"��Ot1Bf0f � -�'��5tr=�0fS � GIBSON COUNTY
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Remnt than Nat d appOtant, omAipte Eelow.
rUme or mortqaqee «mnrac� xoer
nddress ot rtartvavv� or mno-aa
Name W assignee w otl�u awner
naaass
oeau�tio
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I1Wec
ownerl
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my, ynte. aM LP catle)
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Remtl num Page numb�
-b a3a-oo l� i�f6s
6teGness unpaiE as ot Morigage / Contrea i�ebtednrss unpalE as d Is Na e0d�� �e sde
^ m Eate ot avP�� legal «equita0le ame�?
V C/V ❑ Yes ❑ No
tt wrtied wiN sameane dher Ihan spouse. indifate with wlqin
�5 StIC pfOpEfl)' 111 QIICSWLI: /�1111118� �
❑ rtea� a�o�env ❑ !N��a�!vw�ess�
o�v�r �� a�y ang I u y�. �� �ncyr I wne� r�� o�aa I r� �n� aeaw� eee,� aauatm d, �ny
-n N Far arn.w YeaR ❑ res ❑ No
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I�u er ihe natty of perju at Ne above and foregoing infortnatirn is we and correct arW that the appiicant is a resident of IrWiana aM
7act buyer o the afo2me ed property on date appiication is filed.
frhdl rameYl _ _... Date (rtnrtlh. daY. Y��
Pem.on autha�'ved �y CNY ex�
Pdtlress of authoraeE persan
by IC 67.142-07
ciry, sfata, entl LP mde)
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