HomeMy WebLinkAboutMortgage_Barrett (2)p� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN� Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION �
� Stata Fwm 43709 (R11 / 6-09)
�' ..» PreuribeE by DeP���rt of Laxl Govemment Firence
File Mark
iNSraucnoNS: O C T 0�1 � ruaa,w;m:
b be filed in person w by maii with the CounfyAuditol or Counry Recrorder o/ fhe oounry where the poperty is located.
Fiiing Dates: 7J Real Property: Must file dwrrg tha year fix which the deductron is wughc � Counry Autlitor
2) Mobde / Manufactured Hwrres rpt assessed as Real Pioperty. Must Ae dunng the fweNe (f�rtwnths�� � ��ry Remrder
6efae March 31 0/ eech year Ne deduclion is srouyhL ��""=
�; � 7'
See reverse side foradditional instnrctions and qualficatbns. GIBSON COUNTY AUOITOR
(ownararm�vaabyer �ee� pnre' A — w _ ' �
U jV «/iW
' Dittriri Key raim6er / kgal desaiption number Page rum�ha
M-ort�a -ld -300-�0/.5'9S -fl��l o�o .�
raWe d 2al PopertY as of Marrh 1, aartart �irdebteE�a unPaid as af �MOrigag�� inEeWetlness unVaid as d Is�yie� � v�nelt
1.anartyqr
/I �i SOO ❑Yes ❑No
If ro. wha[ is hi5 / her � s1�a�e of NleJesC1
If nartre m remd is Oillerest Nan that of aPpOCant, mEirate 6ebr.
a
:'!:I�I
Name of astignee or atlrel awner a halder d morigage
necass o� assynee (num�r anc saeec rd,: s�are, ene
any
Deduman �poved in tlre artpuN of:
�
LP code)
I/ wmed wtlh mmeorre ather IAan spouse. ud'rate with H/mm
yes. wna[ munry� I What Tav
couNn nuoROr
20 � 20 - � 20
Sig�GaeNCoimiyAUditor �
•i/ We certify und Ne penalty of p
owner I mntrac[ buyer of �he aforer
✓ SlOnanue (ow+�e/s Nareme)
4 ��
XFWrevtlent appGmnt(rwmDe��
/� �.r7Q...S �1��
Puwn autl�or¢ed by Ouy exewcetl Power
AGd�daWwfredperson (n�mGerarc
20 _
County
is C�e property in Quesfim: MnuaAy Assused
� Real RoPenY ❑ %��!aM �
d��a -
DCa\\'Cl' \��..... ..�..........
ca�-a ��o. ....`� 395........ -
-#� / / � � �50. � '
2p _ � 20 _ � 20
Ne aDOVe and foregoing infortnatian is true and mrtect arid that Ne appGCant i5 a resideM of Indiana a�
property on date application is filed.
Data (r�mtl�, daY. Yaa+)
r
tify, smte, and ZIP tode)
d(}; 51Hfe, en0 LP rntle)
Data (rnonN. dal: yea�