HomeMy WebLinkAboutMortgage_Gordon (2):••.'�, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
;i .�� 4 FOR DEDUCTION FROM ASSESSED VALUATION
51ate Form d3709 (RN / 6-09)
f Prewibed by Department d Local Govemment Finance
INSTRUCTIONS:
File
To be filed in person or 6y mail. I Form fitetnmrt ��'
Filing Dafes: 1) Real PropeRy: Must be completed and dated in fhe calendar year for which tba deAuction is sought. JUIV 1 un Audimr
Must be �led with fhe County Auditor or County Reco�de� o/(he county where !he pmperty is located 1 Q� ry
on or be/ore January 5 o7fhe immediafely succeeding calendar year, I � County Recorder
2) Mobde /Manu/acNred Homes nof assessed as Real Property: Must �Ie wifh fhe CounryAudiPor o/the C,�j
counry where fhe property is lowted dunng the rtvelve (f 2) months 6efore March 31 of each year the
deduction is sought.
See reverse side /or additional instructions and qualifications. GIBSON COUNTY A I �nirn.,
ppGcam (owner w conLaa buyer - sea iesnicl:ons on reverse si0e)
Wiiliam A. Gordon and Cathy R. Gordon
Taan9 DistriU
Patoka
26-12-15300-002.845-027
airrent year
5781,700.00
no. what is his I �er ezact share o/ interesl?
II name on recorE is diHerent than that of appticant, inEicate Oebw
'ame ot mortgagee or wnVad se0er
Heritage Federal Credit Union
Etlress of mortgagee w mnVact seuer (numDer ai
5388 Otd SR 66, Newburgh, IN 47630
owner or holder of mortgage
StaIB,
of assignee (number and snaet tiry, sta+e, antl ZIP cotle)
Does applicant own Pmperty in anY oNet I I(yes. what
counryinlnEiana? n .,__ f'1 .._
as
date of apptication
5137,500.0(
as
number
legal or equitaWe ownerl
❑� Yes ❑ No
It oxnetl wiU mmeone other ihan spouse, intlifate wiN xTOm
Is t�e propeRy in quesUOn: MnuallyASSessetl
�❑ Real Properry ❑ Mnually Assessed
on pmpe ,ry
COUNTY AUDITOR
Deductirn aOWd+� N Ne artwunt ot:
20 20 _ 20 20 _ 20 20 20 _
SgnaNre of CounryAWi:or I Gounry I Date (monlh. day. yean
I/ We ceRify under the penalty of perjury thai Ihe above and (oregoing infortnation is We and cortect and Nat the applicant is a resident of Indiana and
owner / conuacl buyer of the aforementioned property on date application is filed.
Sign a(owneYS /W name) Date (monlh. day. yea�
O6I08I2012
Fu resMem add o p- n� number arN stre dty, sfate, antl ZIP cotle)
2567 State d 64, Princeton, IN 47670
Person auNwizeO by dvly exewteG Power of Attomey or by IC 61.142-0J Date (mmN, day, year)
� Atltlress ot auUwrrzed person (numberantl sbeef. city. sfate, and ZlPCOde)