HomeMy WebLinkAboutMortgage_Schuh"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE� n Township Year
FOR DEDUCTION FROM ASSESSED VALUATION -/
� State Fortn 43709 (R71 f 6-09) //
, PresaibeE by Departrtie�ri of Loml GovemmeN Frenca
File Mark
r,vsrrrucnoNS: OCT 2 8 � ��,,,�,,:
To be !(ed in person w by mail with fhe CounryAUditor or Counry Recorder o/ the counry where the property is located.
FiNrg Dates: 1) Real PropeRy: Must fiIe dunrg fhe yrear /or whirh the deduclion is soughL � Counry Auditnr
2) Mobde /ManulaUUmd Homes not assessed as Real PmpeRy Must file during the twelve (t� s�I
6efae March 37 of each year the deducfion is sought ✓��� • ❑ Counry Remrder
Seereverseside/oraddifionalinshuctionsandqualifications. GIBSON COUNTY R
MP��� (ow+rer or m�tra�b:ye�see m.�wrs on re�ersa side) �
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Ta ' DistruY Key �a�m / legal desaiptim Rewrd num0er Page numDri
a� -a3 - o� - doo. 000. � �Y-oo �� o ��s9
A� rahe d real PoD�Y as ol Mp�q� 9e / Contrati inde6ted� unPaid az d Mortgage / ConYact inAebteCn�s �mGaid as of Is Ihe ePP��nt Ne sde
Me�d� 1, amnl yrar Merdi 1, turtent year Cate o/ aDO��� legal Or eQUitable amen
R G� nn n ❑ Yes ❑ No
M. Wi13[ 6IY5 / ilE! CidG
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Nartre of mortgagee ar mntrafl seller
ECIOW.
AdC2ss d nwn9ageE or contrari se�er (number and sneet Ub. 5ate.
Name of assY,piee w other ormer or
Dces apptifam am property in a�ry oNer
munryinlMiana? ❑ Y�
Deducarn approved in ihe artaunt ot
rtprtgage
smte,
No
spouse, (rMkate wuh wtom
IS CI¢ W�PertY ill Q�GSiIOIL Af1�U00y i1�5C55GE
�'FFea�Proaenr ❑?!?�;alNnsesSea
S
arcmal 6 � �/�`
tt yes, what county7 NTa� Ta�dng D'stritt7 Has Na dedum
'-' " - — u.r nurnnt vea(
DAu�- �
2p I 20 I 20 I 20 I 2C
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rea�sae a+ a�v
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�I I We certify undp�the penalry of periu�that the above and foregoing intormation is We and correct and fhat Ne applipnt is a residerrt of Indiana aM
owner I mntrad �iuyer of Ne aforemeiiLOned property on date appiiration is filed.
� Sip (���� rtre) Date Ilmr@4 daY. Y�
FiID resiEent adGess o( appfrant (num0e� and straef, tiry, state, and LP ootle)
oa s. � s �✓ 7G 3
Person auflwriad Gy dWy exewteO Power o(Annney m q IC 6.1-12-0.7 Date (monlh. daY. Y��
AEdrass af autlmr'¢ed pr�sm (number arM sbee; �y, sfate, enC LP cotle) .