HomeMy WebLinkAboutMortgage_Reynolds"�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
___ - FOR DEDUCTION FROM ASSESSED VALUATION
:• Stak Form 43709 (R11 / 6-09)
` � Preusibed by DepaNneM of Lad GovemmeM Frtance
ur ,
�srnucnoNS:
To be filed in person w by mail wifh the CountyAuditor or Counry Recorder o/ fhe county where !he property is located�
Fiiirg Dates: 1) Real Property: Must file during fhe year Por which fha deduclion is sought. n Counry Auditnr
2) Mo6de /Manufedured Homes rrot assessed as Real Property Must file during the M1veHe (72) rt�f� 2 Z i�a �un Reoorder
6etora Ma�ch 31 of each year the ded�rction is myht. i� b
See 2verse side Ioradditional inshuctnons aiM qualficatbns. C���
ownerumntraUbuyer-;eeres4iramsm_ re�e+sesde) v C'\
f�� R��CJ �Cl-' GIBSON COUNTY v
'ng Oistrict Key rwm6a� / legal desoiP� Remrd numEu Pa9e numb�
� a!� -aa- -300-001. �i/-oa ot �� 3`�
pss�uW waWe d 2al paperty as M lAOrtgage / Conb2a intlrbtetln¢s unpaid az W Mortgage / Cantrad uMehtedness unpaitl as o( Is Ne appfinnt the sok
Ma�d� 7, pm¢�( year Martl� 1, wrtent year defe of appGration Iegal w equltade an+wYi
If ro, whal is his / her exaG share of interest?
It rartre on 2oor0 is tliRemnt Ihan Nal o( aDp�ant. 6Micate bebv.c
Name o1 mort9a9ee ar cMUaCt seUer
ACdress of matgagec w cmtrad se�er (number and streeG , sbte.
Name at assignee a WMi wmer w hdder o( mort9a9e
AGA ofassiqnce(numbaraMsbeef,rny,state,andLPjpde) �
L�
Oces applinnt wm prop any oNer tt yes, what munt�!+
ca,nry in InEena? ❑ No
Yes
DaiuCion eowoveO c� the amount ot
20 � 2tl � �
`' � •W � ' V„'
I/ We certify under Ne penalry ot ry Uiat Ne
owner I mntract buyer ot the aforementioned D�I
� � ❑ Yes ❑ No
other Ihan spouse, iMuate wah whom
�Ips tl��e ,p,,ro,�perty in puestion: MnuaDy Assessed
ry •.�. ProPeAY ❑;vmualy Assessed . .
�
R� y NoLo s, �,a�- �
DE 32A s
... /�—//�/
COUNTYAUDROR
_ 20 _ 20 _ 20 _ 20 _
Caunry Date (month, daY. Y��
7
and foregoing intortnation is We and cortec[ arW tha[ the appiinnt is a resident of Indiana and
n date applintlon is filed.
Date (rtnnfi. day, yea�
r.l� 3/.�a laoia
�
Person authorrse0 Ey d�A7r ezenRed Power of AltaneY a�' IC fi1.7-12-0.7
Ad�25s ot aW�v¢ed pason (numOer aM strceL tiry, sb(e. and Z!P ooCe)
oa�e c,�m. ear.