HomeMy WebLinkAboutMortgage_McGrew (3)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES n 7ownship vear
__ FOR DEDUCTION FROM ASSESSED VALUATION
. �• State Fom� 43709 (R71 / 609)
S I p(yyy�p� py pe�rtmeM of Loral GovemmeM Frence
�� MAR 1 5 File Mark
srnucnoNS: 20 ��,,,�,
To be filed in person w 6y mai/ wifh Ne CounryAUdifor or Counry Recorder o! fhe counry where the propertyis located.
Fding Dafes: 1) Real Property: Must file during the }rear (or which Ihe deduction is sought. � �' �� � Cpunty Auditnr
2) Mo6ile / Manufactu�ed Homes not assessed as Real Prdperty: Must file dunng the fweNe (12) months ❑
CounTy Recorder
before Malch 31 oteach yearNe deduction is sought GIBSON COUNTY q
See reverse side (oraddtiona� insWcGons and qualifications. '
r C bv' ' e 25MtbWtt on 2veiSa 5ide)
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Tad^9 �� ' �Y numCer I Iegal�eSaiCtion �ceoota cer r numcer
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Asessetl rdue d rnal Wuperty as W Mortgaga / Contract intle6tetlness unpaid as a( Mongage / uMehteMess unpaid a d Is �he app�xanl �he sole
A1a�N 1, namrt ypar Martli 7, artem yrar Cate o( eOP�� legal w equRaEle amel+
U/ OO � ❑ Ye5 ❑ No
I( m. what a his / her e� share ot intem_st? tt owned wiN somew�e oiher Nan spouu. iMirate with xiwm
If rwrie m recad is dMerart ttan ihat of appG�nt. uWirate bebw. Is tl�e property in qunstion: Mnua�y Asses.ed
. ❑ Real ProPeKY ❑ �^^�' � . . _
Nartre ot rnongagee
Name
contract seDer (number eM sbee4 �y, sfale, aM ZlP code)
noaer ot mortgage
aM Sv2E4 �y. sldle, arq ur caae�
Does applwant oxn pmpeny in any oNu
munryinlnd'ana? n .,__
COUNTY
m
MeG2��, �w�M
A��� �
ja- ��00
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❑ No
—_ 20 20 20 _ 20 i� _ [u _ 20 _ 20
Sigriature NCounbAUditor County Date (��.OaY Y��
I/ We certify under Ue penalry of perjury that Ihe a arW (oregoing intortnation is W e and cortect and that the applicant is a msident o/ Indiana aM
owner I mntract buyer of the aforementloned pm on date application is filed.
y0� ryy Date (rtonfi. daY. Yaa�
G
FWI rrsiEent addmss d appGCant (n Oer and sneet rity, state, and ZIP totle) � �� �
oy amr �ea,;ea v�«�
Pdtlress of a�MUaed person (num6er aM sbeet riry, stafe, aM ZIP ootle)
Date (month,