HomeMy WebLinkAboutMortgage_Walker"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS coun 7ovmship Year
_,. ; FOR DEDUCTION FROM ASSESSED VALUATION
S�te Fortn d3709 (R77 / 609)
�' w� ! Prewibetl by DepartrrierM1 of Loml Govemment Frence
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INSTRUCTIONS: �
To be filed in person or by mati with the CountyAUdito� or Counry Recorder of the county whe�e the property is bcated. Fortn m vn :
FTing Dates: 7) Real Property: Must file dunng fhe yrear (or whirh fhe deduction is sought (J t � 3 2 �unry Auditor
2) Mobile / Manufadured Homes irot assessed as Real Property Must fi7e dunrrg tAe twelve (12J months
6e(ore March 31 oleach year the deduction rs sought Counry Recordu
See reverse side for adtlRionaf instmctbns and quali�ications_ �%l ��
inppfica t(owneraoono-avDuyer-seerestrirta�nsmrevefseside) GIBSON COUNTY AUDITOR
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ITa ' Di � number / legal desaipUon Remtd number Page number
, - �- -�d�. �v -� � � ���
As� ra4e of real poperry as W e/ Contraa'vWeOtetlness unpaiE az ot Mortgage I "mEebteEr�ess unpaiE as o! Is Ne ap�t the sde
Marth 1, arm¢ year Ma . /l Cate o( aOP�� le9al «epuitade ameR
� C�O ❑ Yes ❑ No
I( ro, what fs ha ! her a�a share of interest? If ovmed wiit� sorneone dher than spouse, indrcate wiM wtwm
If nane m remtl s 6Rer�nt lhan Ihat W app6ran4 inEirate bebw. I the propefty in puestion: MnuaOy AssesseC
�naenv ❑a�r,�,a�Na�s�s�a
r.+oax � ic ��.�-
I Name o1 mortgagea a mntraU seller
I Address d �raD3agre m m�traG seAer (num6er aM shee4 ciry. sta�. aM ZIP code)
_
IName ol assignee w othei awner or hdder ot mortgage _
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Add(essofassig�e(nurtiOeraMSlreeL�y.slete.andZ/PCOtle) _^ � /LI "J
^ � i
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Oces e�piifant avn poperty in any other If yrs.' W � S� N K� iedutlion Oeen 2questetl m Pmperty
munryinlnaana? ❑ No ��n ❑ Yes ❑ No
❑ Yes
DeducTOnappmved'v�tlreamountof. " - �� J �� � �
20 20 20 20 20 20
Sigranrte of CounN AuOitor Counry oate (rtanM. daY• Y��
I I We certify under the penatty of perjury Nat the above and foregoing infortnalion is We and correc[ and Nat ihe applinnl is a resident ot �ndiana aM
o.mer / mntrad buyer of Ne aforementioned property on date application is filatl.
Si�rpnue (���� Date (rtw#h. daY• Y��)
%� �Z -3Q-Zdo 9
FWI ent af appi'�nt (number and strce4 �; ��8, � ZIP ootla)
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Pr1sm auttq�� Gy dWy e<eated Powe� of AtlnmeY a bY IC 6t.1-t2-0.7 Date (rtmN. d2y, yea�
Pdtlress af authoved person (number arntl stree; crty, state, aM LP coCe) .