HomeMy WebLinkAboutMortgage_Wallace (2)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun'
•Y ..
+ FOR DEDUCTION FROM ASSESSED VALUATION
• State Fam C3709 (R71 / 6-09)
S � PresaiGetl by Departmem ol Laml Govemment Frence
�STRUCTIONS:
To 6e filed in person or 6y mail wiM [he CountyAuditw or Counry RecoNe� o/ the oounty where the pioperty is located.
F�7irg Dates: 7) Real Pmpe`ry: Must file dunrg the year (or which fhe deducfion is sought.
2) AbbAe / Manufactured Homes rqt asseued as Real Property Musf file dunng the fwelve (12) months
6efore March 37 of each year the deducfion is sought.
See reverse siAe for additional insWctnons�tl qualificafions. �
^(flmerar mntraa byyer- see re � dn rererse side) . n //
Ta " V� Ke ber/ aldesaipU
-3�
vdhie d real pmperty as of Mortgage! Can
1. Wmn� year March t. arten
I( ro. what a his / her e� share af interest?
If name m m�orC is WHerent Wn ihat of appfi�nL md'uate OebMc
) 1
Name of mwigagee m m�tract seller �7 �
Year
� �njy itor
nty er
GIBSON COUNTY
- v - Uo . .�-Da O// � ja'
tract indebtetl�ss unpaid az W Mortgage I Cmtra�1 i'WeMeCnrss unGaid a af Is Ihe eVP�� tlre sde
t yeer Aate o( application legal n epuitade vmre(�
p� ❑ Yes ❑ No
If awned with someane dher n spouse. i(Wi�ate with wMrn
rtnrtgagee or mntracl sr�er (numDe� entl�lj@e4 �Y. slate, antl
//
signee a oNer owner n MAU of nprtgage
AdEreSS of a�mnce (numOer eM Stree; City, 51dfe, an0 ZIPGOde)
�.I
/
/
eod�m�� � P�Peny in any dher
----� - n
vos
No
I! yes, what muntyl
�e O�OQnY in QuestiOn: MnuaOy A55es.uE
Rea�Proaero ❑.wmua�ywssessed
.53 _ � -// /. 3a,9�
Nrtat Tarirg Distritl? Has inis tleCUUion Eeen reQU�ted m property
ro, wnm, rean
❑ Yes ❑ Na
Dra�ti�er i\'0....."��� �.......
Cat•d ' , s�!.S ' zo zo zo zo_
t\ O. . .
� �� I C� ' • • • • • • . . . . Counry Date (rtpnN. day. yea�
J �
I/ We certify under the penany ,,. �_ _ aM foregoing information is We and cortect and Nat Ne applicant is a resident of IMiana and
owner I conVacl buyer of the aforemenUOned pruy...., m date appliw5on is filed.
�qature (owneY: hArmrtre) Date (nmSh. GaY• Y��
Futl
(numEer ard sfreet �ry���e, antl ZIP aotle)
q'
Pddr�s of autMmEd person (number aM sbee; cdy, state, antl ZIP catle)
Date (monlh. tlaY• Y�h