HomeMy WebLinkAboutMortgage_Wirey"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C n T w hip Year
_ � FOR DEDUCTION FROM ASSESSED VALUATION '
• State Fwm 93709 (R71 / 6-W ) -
� � Presrnbe0 M��r�t of L.aral Govemmem Fu�ance
SEP 1 8��@��
iNSrRUCnorus:
Fwm Ned with:
To 6e filed in person a by mail wi[A fhe County Auditor or Counry Recorder ot Ne counry where the pmperty is located.
Filirg Dates: 1 J Real Pmperty: Must fda durrrg the yearlo� which tha deduclion is soughL �,z�., �/.� Counry Auditw
2J Mobde / Manufactured Homes rrot assessed as Real Pruperty Must file dunng the M1veNe (7Y) months a j�1 .C�
beforeMarch37ofeachyearfhededuclionissoughG GIBSONCOU TYPrtDIfV�iryRecorder
See 2verse side !o� adtl8ional instmclions arid quaJj(rcafions. _. _
arrenc year
Iq.'A'�12i 6�IK I�121 Cl2L� 5�121U O( II1�CRS(7
�. I Coniraa inde6tednrss unpaid as of
�i"`�'a 3 . 3 0
tl �unie m mmrtl is 6ftrmn Wn that ot a7G��t hWicate bebw:
y�y-.r.v.^�_�'i
N�
atraet, tdy, stam. ard LP cade)
w holder M rtwrtgaga
naaress a� assgnee (nurrmer aln srree; cuy, sere, ara ur cooe�
f�:'_i
2tl
any oNer
Yes
WNo�
�
2q
�iw
W�at Tadi
AUDROR
20
County
Record numbrl � Page numCer
�mpaid as d I Is Ne epP�^t Ne sole
legal w eyuitade ovmM
n Yes ❑ No
Is tM prope`ty in pur..Gm: MnuaDy AssesseC
❑ Real FvPe�b ❑ %�^^�Y �
Mo6ile Hame (IC 6
�M A
D 1':l \\' C 1" ��0 . . �S�!� •'. . . . ..
✓v':O �....
Ca1'Cl NO. .......
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N1 1 20
Y��
20
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I I We cert'rfy uMer Ihe penatty of perjury that the above and (oregoing infwmation is true and cortect and Nat Ne appiinnt is a 2sident of IrMiana and
owner I mntrad buyer of the aforementioned property on da[e application is filed.
C.1
state, arM 2/P cotle)
�I,.� l ZLoZi 1
hAy exeaIIed Pov.er otAltort�eY � M IC G1.i-12-0.7 I Date (mon�h, d2Y. Y��
person (number antl strce; dry, state, an0 LP code) .