HomeMy WebLinkAboutMortgage_PenningtonSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__,. FOR DEDUCTION FROM ASSESSED VALUATION ,/
State Fotm C3709 (R71 / 6-09) � [/
� w. Presm'Eetl tr9 �rd o1 Lod GmemmarC Fu�arce
f�(
INSTRUCTIONS.
b be filed in person or by mail with the CounryAuditor or Counry Recorder o/ Me county where the pmperty j�,qFdteA. �
Filing Dates: i) Real Property: Must file dunrg the year for which the deduclion is mughc �v u v a �
2) Mobde / Manulactured Homes not assessed as Real Properly: Must Ae dunng the nveHe (72� months
befaa MarCh 37 o/each yearMe deducOOn is sought. �j�- /�
See raverse side for adtlrfional instructirns and qualifications. l�' � 6� `"'
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'�P°�°m�ON'�`OT�br�`"�n�B`erses°BT --,-- \ GIBSON COUNfir
tcey mimber /
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tt ro. wnaz ts t� / rrer ema snare ot inteJest?
tt rwne m recoN is 6ltumt Cun Ihat af app6wrt, 4dirate Mbr-
wma of rmtgagee a aoncarl seu«
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Name d�re or oNU wmer ar h
S
mortpaga
AaaRSS ot assgnce (numDer aro sdee; ary, stete. aria tJr caoe)
Dce9 8�l(2flt bMI pOp¢fl`/ V1 811`� OfI1M Ii YPS, M#12t mUfil`�1
c�unry�niwena? ❑ res
� ❑ No
amount
1111_T�
—�d
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� CounryAUd'rtor
❑ Counry Recorder
Remtd num0er Page rumAa
av v �
bteGress �mG� as of Is ihe ePG�� Na sde
�a��
❑ Yes ❑ No
spouse, IMkate yitli whom
Is ihe pmperty in Guestim: MlwweDy Assnsed
� aovenv 0 a,�!,a�N a�ud
Dra�vcr NO....:.°.��it��.....
c�ra ��o. ....... y3\l� ....
�; ����v�
i.��
20 _ 20 _ 20 _ 20 _ 20 _ 20 _ 20 _
Signauae ot Cpmty Autlimr . Counry Dete (rnonM. daY. Y��
I/ We certify under Ne penatty W perjury that Me aDOVe arM foregoing intortnalim is true and corte� and that Ne appli�ant is a resident of IMiana and
owner / wntract buyer of Ne afofementioned property on date appliration is filed.
�Si"at�re (owners NO naRe) \ , Date (month, deY. YmeA
Fuo resiaem a�� w epp�enc ( Defan'tlISLBB4'dN 5ete. antl LY cd
� So� (.�.i ST/Lcl o$ f-tu,.�.(b�r�,S�+ �
Pason aWiaaeO Dy Oldy esewie0 Power of Atiomey a Cy IC F7.7-12-0.7
Address N auCror'ved persm (numbereM saee; ury, smte. antl LP rode)