HomeMy WebLinkAboutMortgage_Kassenbrock"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ovmship Yea
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. FOR DEDUCTION FROM ASSESSED VALUATION
- �• Sta[e Fortn C3709 (R71 / 6W )
�` � � Presfiibed by �epartmen� of Loral Govemment France J
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ile M
1NSTRJC.TIONS: - � A �
Fmn Ned with:
To be ned in person w by maii with fhe CountyAuditor or Counry RecoNer o( fhe county where the property is located. �
Filirg Dates: 1) Real Property: Must fi/e dunng Me year for which the deduction is sought. � ���ty quditor
2) Mobile /Manulac[ured Homes rrot assessed as Real Pmperty Must rle dunng fhe twelve (12) months ❑
6efore MarcAr 37 0/ eacli year fhe deduclion is soughL Counry Reoorder
C .
See reverse side tor addilional instrucfions arM qualifications.
qPpfron wnerwmno-ryaeb �see mreversesiee) � GIBSON,COUNTYAUDITOR
/ � �
T' isma KeY rvunbrr / kgal desaiPtion _ _ Recortl {wp�per Page numbet
vdue d real P�Pe�Y �
` ctarent lror
�
If ro, what fs h¢ I her e�ad share
If rertie on lemd 6 E�tRurnt Na�
uiEicate beb�r.
Name of rtwR9a9ee ar mntrad seller /� C
C
Addren of mortga9ce ar cantract se0er (number and sbeeC ciry, state, aM
Name ot assignre w W�er awner or twlder of mort9age
AdEass o/ assignce (num0er aM svicet a+Y, s+ate, aM ZIP ootle)
Oces applirarLL axn poperty in any oNer If yes, whst munry
cwnry in Indiana? � Yes ❑ NO
1 as of Mortgage / ContraG i�Mebtedness unpaid as a( Ls the appliwit Ne sole
Eate of aPpGCatm �gal a eWrtaWe ownM
❑ Yes ❑ No
IF owned wiM mmeone other Man spouse, iidirete wiTh whom
Is tM DbPe�Y in Ouestion: MnuaP/ Assessed
❑ Real a�oaenv ❑ rvm!�aM wsses5ed - - -
Has Nis deAUaion Deen requested m property
tw arren� Ye� ❑ Yes ❑ I