HomeMy WebLinkAboutMortgage_Reinhart"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS h' Year
FOR DEDUCTION FROM ASSESSED VALUATION
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To be filed in person or 6y med witl� the CountyAWitor d the county where Me property is Mcated.
Filirg Dales: 1) Real Property: Must file dunng fhe year for which the deduc6on is uwght.
2) Mobi7e /ManufaUured Homes not assessed as Real Property. Must file durng fhe tweNe (12J mmths��l�i,8�q1 earh year
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SeereveisesdeloraddAiona�inswctionsandqua��ficatims GIBSON COUNTY AUDITOR
Key
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Mortgape / Contrad indeblednea unpaid as N
Maich 7, turtaM Year
u name m remnt b calarem man ma� or apvr�ra �dimm ee�o.r.
Name d mMgagee or oontrad seAar �_] �
AdCtess d morigagee or tmirad se0m (mmDerand sheel �Y. s6fe, and ZIP code)
Na�re d assignee w other amer a hoidar d matgaga '
Atldress d asignee (mimEOr and sbeaG dl: sb�, arb Z!P mda)
m
Does aV0�1 own paperty in am� alher H yes. what couM'?
CouMy in IMiare?
❑ Yes ❑ No
COUI
DeEUCtion a7Crwed m Ihe amartq d:
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W:IBf IM1NI SGa�9B. IIMIf2IB WIU1 WMIII
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� 119,00c�,ut�
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r epuihGe owne(!
❑ Yes ❑ Na
Is Ne popeM in auestiar. AnnuaOy Assessed
❑RealP�vperty QMnualy0.ssessed
deeuaion eaen rawested on v�oaM
��R ❑ Ye5 ❑ No
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I/ We certfy uMer Ihe penalry of perjury ihat the above and fwegoing c�famatbn is true and cwred and that Ihe applicant is a resiaen[ of Ind"u� and
owner / mntract buyer of U�e aforementioned property on date application is filed.
by IC 64.
Addrass d aultarizeE 7erson (nurtiDOr andsheet my: sbfe. and Z!P wCe)
(mmm. aaY year)