HomeMy WebLinkAboutMortgage_Metcalf� �o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
i._._. 4 FOR DEDUCTION FROM ASSESSED VALUATION i
i:' i !:
� ' Slate Form a3709 (R77 / 6-09)
-� Prescnbed Cy Depanment ol Local Govemment Finance
�INSTRUCTIONS:
To be �led in person or by mail. Fo�*�wiN�� 201 �
Filing Dafes: 7J Real Property: Musf 6e completed and dafed in the calendar year7or which the deduclion is sought. G
Mus( 6e filed wifh (he County Audifor or County Recorder o/ the county where the property is located Counry Audiror
on or 6elore January 5 o7the immediafely succeeding calendai year �� o rder
2� Mobile / Manulactured Homes no( assessed as Real Property: Musf (!e wifh the County Auditor o/ the
counry w6ere (be property is bcated dunng the Rvelve (12) months before March 31 0l each year the
deduc�ion is sought. GIBSON COUNTY AUDITOR
See ieverse sitle for additional instructions antl qualifica[ions.
pptiwnt (owner w conUatt buyer - see resLirtions m reverse vde)
MICHAEL D METCALF AND DEBORAH M METCALF
JOHNSON I 2623-11-200-002.170.024
AssessM vaWe W real pmpe ,ry as ot
h7artl� 1. amen'year �� �OQ
�l�
If no, what is Ns / �er exact share af imeresi?
Mwtgage / Contratt iMebtedness unpaid a5 W Mon
March t, wrt�y�r � Q tlate
✓lJ
It owneE vnV1 �
If name on recortl is Cifterent t�an that o! applicant, intlicate bebw.
Name oi m gagae or mnVa'^^ n s-11e^
I / �W r �
Atltlress of gagea or ntrdc� se�er number and sireet, c s
`�o �x 6a �`�
Name of assignea or oNer owner or Mlder of mortgage
Address of assignea (numberand sireef. tiry, stafe, antl ZIP cotle)
any ol�er � � It yes,
a�b/Pit- �� �{'15�'%
numDer
az of Is Uie appGwnt Ne sde
legal orre�qw�table owner)
Q res ❑ No
Oun spouse, indiwte wiih whom
Is Vie perty in questbn: MnuaDyASSessed
eal Pmperty ❑ MnualyASSessed
Mobile Home QC 61J�
Has Nis tledudion baen rapuasteE on property
for curtent yea(?
n Yes n No