HomeMy WebLinkAboutMortgage_Singleton (2)�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
��_ = FOR DEDUCTION FROM ASSESSED VALUATION
• $tate FOrtn G3709 (R71 / &09)
� y�. PRSaibed Oy DepartrtieM of Lotal GovemmetLL Finance .
File Mark
irurnucnoNS �
b be Red in person w by mai7 with the CounlyAWitor w Cowry Recorder o! Ne counry whe�e the property is located.
Fl7ing Dates: 7) Real Property Must file durirg the year for which the deduclion is sought Counry Auditw
2) Mobde / Manufactured Homas not assessed es Real Pmperty: Must file dunrg the hveNe (72) rtanths �—.
6ehre Ma�ch 31 of each year the deducfion rs swght. a� ��ty Remrde`
See2versesid�additionalinstruclionsarMqualifications� GIBSON COUNTY AUDITOR
fno D�re�-���«��,�,� " . L_ I
��,�T��(�-�8-3�-3oo-ooa /(�S a� 0 P � � 7
f real P�O�Y as of t,wr�ag e! Contraa Webtetlness uMa+� as of MMgage / Contra(Y cWebtedness �mCaid as of Is Ne aPP�� Ne sde
ym Mem}� 1. wmm Yeer � D�Q� aata o! eaP�� �❑ Y� ❑ oN
/ tcef e�l share ot interest't tt awned uiN somearre dhar than spouse. Indicate with wtrom
d'o ScRerent Nan Ihai of a00��. tr�tlirate Eebw. Is ihe P�7MY in Ouestion: MmiaPJASSessed
� Real PmpeKY � Mmi�al�i! 0.s� .._
of rtnr�ee «wntrari seller
01 `mrtpapee a cantract seAer (numba and shael, ciry. smm, aM LP
Narne ol essi�xie a ariv owner or nmer rn rtnrtgage
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rsident adtlmss
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penalry oi ury tha
otihe entlonec
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cant ( ' ber and sLee4
4Mat Taring Districll
COUNTYAUDROR
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Counry
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20
Date (month. daY. Y��
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Ne above and foregoing infortnation is we eM mrrea arM thai the applirant is a residem of IMia� and
P�PenY on date ap�rcatio� is filed.
. Date (nwiCi. daY. N�/)
antl ZIP mda)
.a .. 1_.tn ii 1� 4-7 (n 3 i
w by IC 67.142�.7
autlior'ved penm (number and wee; dry, sfate,
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