HomeMy WebLinkAboutMortgage_Emilio^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C�u T n i Year i
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
• � State Form 43709 (R71 / 6-09)
�,w f Presvibed M ce7��N ol Lod Govemment Firence
INSTRUCTIONS: �AN ��le ��
To 6e filed in person w by mail wifh the CountyAuditw or Counry Recorder o/ Ne county where the property is located. C� F� �n�,;���, S�
Filing Dates: i) Real PropeRy: Must file durirg the year /or which the deduction is soughf. nry Auditor
2) Mobde /ManulaGured Homes not assessed es Real Properly Mus! fiie dunrg the hveNe (12J months I�I
6efore March 31 ofeach yearfha deduction is soughG GIBSON C UNFi' A er
See reverse side (or addihonal insLUCtiwis arnl qualfications.
Ao 4�owrer or mntraa 61Me� -�F re�75 m reve+se site) ^ ._ .
) Key wmO�r /�gal desdintirn Rem(d numDer Page num6�
� �v- a - .� -,3oo-aoo.oi�-oa ao� r a8.�
as al Morya ge / Con�ati'uW�tedness unpaid a d Mongaga I ContrxY rtdehtedn¢s unpaid as d b the epp�rant tlie sde
MaRh 7, turre�nt ` tlate o( appOtation @gal ar epuitade ownM
��n Y.Q � � ❑ Yes ❑ No
what Is Ns I her ezad share OI interesl?
It name on mmd is QRtbent than
rmtgagce «mntraa
mnbaG se0er (numbrl end streeG cCy, sfate. arN LP code)
oNer owner rn MIAU M martgage
ACdress of a/sJ��� (numOer arM atree4 my, sbte, and Z/P'co/de)
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Dces epplinN rnm p(operry in any alher If yes, whal munry
�^y�i^em�aa � .,__ n .,_
ef
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If awned wiN someone oUrer tlan
o?. S o /+ C
NRa� Tav�tg �aGiU7
COUNTYAUDROR
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Is ihe propeny in Qurstian: Mnualy Assessetl
�Real Ropc'nY ❑ nnru,aMwssesud
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I I We certify under ihe penalry ot pe ' that Ne abo a'W foregoing infortnation is true and wrtect arW ihat the applipnt is a resident of Indiana arM
owner I contraa buyer of tAe aforementioned prope on date application is filed.
��atur¢ywne/s�e) . Date (monlh, day, yee�
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o msiwei'r t adams w appfrcant (numeer ane saeet dry, srate, ane ZIP coce) _ _ _
�y diAy executed Powm1 of AtmmeY or by IC F7.1-12-0.7
per'.on