HomeMy WebLinkAboutMortgage_Chandler (3)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN� o ownship Year
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FOR DEDUCTION FROM ASSESSED VALUATION
Sfale Form 43709 (R11 / 6-09)
�' , ° Presaibed Cy DePartment of Wral Govemment Firence
�srnucnoNS: JAN 2 5 2012 File Mark
To 6e filed in person w by mail with the Co�nryAuditor or Counry Recorder of fhe county where the property is locat F� ���
F�7ing Dafes: 7) Real Pmperiy Must file dunig the year /or whicA Ne deduction is soughL C-�-r Counry Auditnr
2) Mobile / Manufactured Hwnes not assessed as Real Pmperty Must file dunng the twelve (12J months
before March 37 ot each year fhe deduction is sought Counry Reoorder
See reverse side for additional instmcGons and quali�cations.
GIgSON COUNTY
�pf/ /( n%lor({��t+aGbuyer- ee ' r@versevtle)
!J A\ � -/ � � ��%
number I legal desaiption
�.,_,sr_ �/.,.i
f vaYie aF inal pmpPny as
nr�en[ yPN
nr ent
I! ra, what is tus / trer exarl share of
If riame on 2curG a dAtefent than Mai of appfxan6 uMipte bebw
seller
Jt..L-'T^'-v'�1:3`
rvame ot asvgnee w omnr owner m ndaer w rtnrtgage
srate.
naarass or assgnce �numcer arro s+me4 �++Y. su�e, arp ur cooe�
Does applifant wm yoperty in any aNer
munry in IMana? � . _
20 � 20
�� oo� �3y 9 da Y I
intle0cederess unpaid as af Mortgage I ContracY mdebtetlness
� dau ot appGCatim
n yes, wna[ munryr
�
COU
20 20
sameo�re dMr tlun Wa+se.
Recoid numher Page numCU �
unpaitl as M Is i�e ap ' t t�e sde
�gal a eQUitahle owneR
n Yes n No
i3 NC �fO�CfI� RI QIIPSbML /Vlf W2�% iISSCS520
�2� PfOpClly � ��.II(1U3�� /i55CS5Lb
neobae rwm� nc 6
�' (y����
- C:���,o�-�� �,�
��,�8�5
20 � 20
C�p
ed m praperty
• r.s ❑
_ 20 _
ate (month, day, Y3a�
I I We certify urWer Ne penalry of perjury lhat Ihe ahove and foregoing infortnation is true and cortect and Ihat ihe applinnt is a resident of Indiana and
owner I mntract buyer of Uie aforemerrtaned property on date appliplion is filed.
tlry, state, and LP oode)
ZG3 /,U. �'.�i,t/<i/KG ,Z�i?. �.Q/.f.3S �,oe
on autfmraeE Ey EWy ezecvteG Power af ArtomeY rn Oy IC 61.1-12-0.7
person Inumoerand sveeC pry. state.
Date irtronM, day, yea�