HomeMy WebLinkAboutMortgage_Vanover"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS c _ T ip vear
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, FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (Rtt / 6-09)
,' ,�,� ` Presrribed by DepanmeM ol loral Govemment Fnance
wsrRUCnoNS:
MAY �+�e �28d1
To 6e filed in rson w 6 mail wifh the Coun Auditor or Coun Recortier o! the coun where the ro Ffl� f�
Pe Y �Y 4' �Y P PartY is bcated. C. .
FiNrg Dafes: 1i Real Property: Must fde durng the year for which !he deducUon is sought. Auditor
2) Mobde / Manufactured Homes rat assessed as Real Prtiperty Must file dunng the IweNe (12J months ��1� h
6efaeMarch37ofeachyearthededuclionissought GIBSON OUN�lYl�O¢9�FFO1de+
See reverse side 7or additional insUUCfions arM qual�rafions.
AppGmni (°�( or oonlrvG bu}w- see res7lir�DUns m reeerse snide)
V Q9l x a�c� r,-, 1.'1 ,.v.�.-U ..� ��t Q sa w,at�. T
f vdAie of mal piopHty as d
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Key rnAnber l le9al tlesai0tion RemN numbei Page numGu
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Alortgage / Contract intlebtedness unpaid as d Mw�qaqe I ContraU iMebtedness unpaitl as o( Is Me appb'ani Me sde
Mamh 1, a,rOma,e yrar eate or sppGntia, legal o, equitade ownen
p D� ❑ Yes ❑ No
terest? If wmed witt� someone ather Wn spouse. iMimte wtrh whom
seDu
or ottur ovmu or hdder oi mortgage
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Dces aPptimm wm pfoperty in any oNer
munty m InOiana?
❑ Yes
Detluction appmved in Iha amount af.
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s��awre m c«ma a,a��
eef, cdy, state, eM LP code)
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If yes. Mu
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I I We certify under the penalry of perjury Nat ihe abov[
amer I mntrad buyer of the afaementioned property c
7natur�(ownefsluuname) . (�
auNOiaed Dy
Addr�s of aWrorved prlsw� (num0er aid sneef, dry, uafe, and
GS Sh2 �f0�l.'fi� III QIIPSSqfL i1f11W8� ASSCSSCd
❑ Reai ProPerfj ❑ Mnually Assessed
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