HomeMy WebLinkAboutMortgage_Duncan�
�
'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Couni
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R71 / 6-09)
S j Presaibed by Department o( tnd GovemmeM Finance
INSTRUCTIONS:
To be filed in person w by mail with the CounryAuditor or Counry Recorder of the counry where the pioperty is located.
Filirrg Dates: 1) Real Pmperty: Must fi!e durirg the year for which the deduction is sought.
2) Mo6de / Manufactured Homes rat assessed as Real Property: Must file dunng the twelve (72J months
6efae Maich 37 0/ each year the deducfion is sought.
See reverse side for additional inshuctions and quali�cations.
1(ownerar mn7arl buyer- see restiiltions on reverse SiCe)
�
I �- .��ypy Auditor
❑ Counry Remrtler
GIBSON COUh i Y Nu�� ��^
� rvunber l legal dewi � Reco�d number Page num6er
�- //- /(v -d� -oo�, ass - o a 7 ,200 9 3� a
0.s¢seE rWue oFinal W�Y az N Mort9a9e / Contraa irde6tedness unpaid as W hbrtgage / Contrad inEebtedness unPaid as of Is ihe aCWirant the sole
MmGi 1, arrern ym Mard� 1. wrtem Eate of aVP��� � a W�oade avmefl
D D ❑ Yes ❑ No
If ro. what is h'a / her e�otl share ot intnJest? If ovmed wiN snmeone dher Ihan spouse. 4Wiqte wBh Mqrn
If name m 2m�tl is dMerent ihan Nat ot aPplkant, Induate bebw Is C�e property in pues5on: Mmw�y Pssessed
Real Pmperty ❑ NmualyAssesud
MoGle Flarne QC b1.1-�
Name of mort�a9ee a mnirxl sed � / �• /f �
/'1
i � '�l
w mnbaci
fher owner
ss at assignee (numDer ard stree; rity, slate. end LP code)
applimnt o.m property in any oUc M yes, wh
Y �� ��g��
❑ Yes ❑ No
..�sm:-a,
20 _
Sigrianne d Camry P�uditor
I I we certiry er fhi
owner I conVact buyei
aMLPcode)
cour+rr nuoROa
Drawer NO.... a�9.....
Card lr'O. ...ti-lulv?�.:........
� �y �i� � �c�
20 20 _ 20 _ 20 _ 20 -_ 20
3 cwnry oace (mmtn. dav. N�A
penatty ot pe - ry that the above arW (oregoing infomiation is We and cortect arW that ihe applicant is a resident d IrWiana and
ot Ihe afaementioned property on date applica0on is filed:
Date (month, daY. Y��
7 7��� S�C? �✓� �i' iNC.Sro�
Pason autlro�¢ed Dy uh/ exewteC Power ol Aitomey w Gy IC G7.1-12-0.7
Pddress of authrn¢cd person (number arM sbee( dry, sble, aiW LP catle)
7
�r, r��