HomeMy WebLinkAboutMortgage_Bryant (3).� °'* STAIEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
= FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (R8 / 2-07)
S aw � Resmbed by Departmenl o( Local Govertunenl Fi�nce
File Maric
INSTRUCPONS:
To be filed in person or by mad with the CountyAudifor ol the county where the properfy is located. Q N K 1 20 � 8
Fd'mg Dates: i) Rea/ Property: Dunng the 12 monUis be(ofe June 77 0( the year the deduc6on is to be eRec6ve.
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 75 end March 2 of the year the d uc6on is to be effeclive.
See raverse side for additanal insWCtions and qualilcations. �� ��
Applicant(owneinconlradbryer-see�ctlmsmreverseside) h ("� � GIBSON COU
Key ndlntier/legaldesaiption (
��t�,._ � ot �-�
ralue of re� popaty as of Maich 1, wrent yrar Morigage /
aiRenl YZ2
'�hat i5 his / her exacl share of irrten
If teme m record is different Ihan Nal of .
Name mortgagee rcanlracfseller
Address of mortgagee a mn�ract 5eller (i
Name af assignee or oU�a owner a hddi
Address of assignee (mmiber arM stieal,
Ooes applicant oxn property in anY dh�
counry in Indiaria7
❑Yes ❑ No
Deduction
�
intliple belo.v
sfafe, arM ZlProde)
oty, sfate. andZlPtode)
If yes, whal
amount of:
� � 1 �
1/ We cerEfy under�penalty of
Indiana and owner e aforeme
»uuE(o�rs hdl �me) � �
aullwr¢ed by duly executed Power of Alidriey
the above and for•
�erty on Ma`ch 1,
Address of author¢ed person (num6er arW street cAy, sfate, and LP oode)
unpaid as of March 1,
If wmed with mmeone
RemN
appGmnl Ihe
spouu,
or equivae owner:
❑ Yes ❑ No
Is Ihe property in queslion:
❑ Real Property � Mobile Harie QC 61.
_ �� J� �Yl►�� y a
_ ��� ���-
' �� 0�G1� �
,�,�Y �tir
��- �a �o
asted on properly
�Yes ❑No
20
"n�i- o�
ere a resident of
yea�
—_'� _
Oate (rtronN, day yea�