HomeMy WebLinkAboutMortgage_BarberSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
, FOR DEDUCTION FROM ASSESSED VALUATION
saca F«m a37os IR71 / s-os)
� Presaibed by Depa�tment ot Lxal GovemmeM Frenca
File Mark
INSTRUCTiONS: � ' � •
To 6e h7ed in person or by maii wiM the Counry Auditor w Counry Recorder o! Ne wunty whera the properry is located.
Ffting Dates: 1) Real Property: Must file durirg the year /or which Ne deduction is soughL � Counry Auditor
2) Mo6�7e / ManulaGUred Homes rwt auessed as Real Prt�perty Must file dunng the nvelve (72) months ���
6e(om March 31 of each year the deduclion is sought � ry Rec°^tlu
See reverse side foraddifronel instniubns and qualficatbons. GIBSON COUNTY AUDITOR
T' .strirl Key rwrti0er I le9al desviption Remrtl numDer Page numErl
� ab -os- o-�o� - ao�. � r? �- o a. 7 0�o y
Asse�� vdhe oF real PoPeM1Y az d Myy� ge/ Contrau 4dMte0ness un0� as U Mongaga / Conaac['vWebietlrmss unG� as d Is I�e ePP�� tla sde
Ale�rh 1. aimn yrar Mart3� 1. airtmt yrar date d epp0�tion kgal a ePnlade aw+'eR
� (�O ❑ Yes ❑ No
rc �o. what is hs � nu eno slwe or inee,PSn rc owiea w;m sonreone ahei u,an sv��. uvcace witl, vAron,
If nazna on'emN iv dilferent than Nat of app�an4 �� bebw' I yoperty in Question: Mr�w�y AssessM
Real �peKY � A^^�Y�
• MoG1e Flortie C 61.1=,
Nama N mort9a9ee v wntracl se4er /J � � _ _ /J
ACdresa d mortga9ee or mntreU se�er (numbe� end stree; r�lY. stam.
u dher owner rn halEer of mMgage
Ma�azs ol assynae (numDer saee4 �Y. s+sle. and [Ir 000e)
� Ti�-� 3l - -io /. 8� � c
Does e�piimnt am pmperry in anY oMer It yes, whal county� NTat Tan�p7 Disvirl7
oounry m Ind'ena? ❑ Yes ❑ No
imm apprwed'ci Ihe amouM of.
20 20 _
Sig�hrte U Caairy Auditor ^
iCl �i
I/ We certify u�er N penatty of perjury
oyaw� / contraa buyer of the afg�gme�roc
Prlson
m proprity
❑ No
___.__ _ _________ –
Drativer i\'O.. °Z o/o-.... -
20_ 20_ 1..a7.C� 7 • _
. i���. ..../°< <%� _
Caunry - '• .•......
the above and foregoing informatim is true n� w...... _ aM
ProPenY on date appliration is filed.
or by IC E7.142-0.7
� 7
FdEress of auCiavEd De�^ (numheraM sbeet b�: slah, an0 LP mAS) . I
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