HomeMy WebLinkAboutMortgage_Hancock (2)°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Year
FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fortn 43709 (RB! 2-07)
S y,� � prasa3ed by Depariment of Lacal Go�emmerrt Firence
INSTRUCTIONS: S E P Mark
To be filed in person or 6y mad with the CourttyAuditor o/ the comrty where Me pioperty is bcated.
Fd'vig Dates: 1 J Real Rvpe!(y: Dunng lhe 72 rtronths be/we June 17 of the year the deduction is to be eNective. � ,Q
2) Mabile Homes assessed'mder IC 67.7-7: Between January 15 and Malch 2 0l the year the deduc6m i�O be e 've.
See raverse side fa additiorral ins6uctions end qualificafions. GIBSON COUNTY AUDITOR
is his
I If reme
Key number / legal desaiption
a -��-� -�od_
March 1. wrent Y� �Ba9e / Contrad
wrrent yea� � _
� I
Nartre of rt�gagee or 9m'�^a s����-�-
v�
Address of moM1gagee a mniracl seller
� Name of assgnee or olher owner a
������
I Does e
couray
2b
indirate belav:
(M�R16BI aM stiee� pty. Stale, antl [IY CWe)
xopertY in arry dher li yes, what caunlY?
Yes ❑ N
couNTv
in �he arriamt of:
� SigraWre of County Audilnr
2p I 20 I 20
� Reco�d mm�ber
-� o a 7 aoo �
unpaid as of Marrh 1, Is Ihe appFCanl the sole I<
If wvned with someone
Caunry
Page nurt`�b/er�i
��6 �$
❑Yes ❑No
whom.
kIs,I�he property in queslion:
}�xeal Property ❑ Mobile Horne (IC 61.
Drawer ND••�...
10� g
Card��• ..............� ... on�
ca.,dow,,;,� � � �"69 0`6 • 5❑ No
P� T�-�—� ��
20
20 20
Dale (rsmlh. QaY. YeaA
I/ We certify under the penalty oi perjury that tlie above and fwegoing in(ortnation is We and mrred and fhat tlie appGonts was I were a resident of
Indiana and owner of fhe afwementioned property o� March 1, 20
i elowneYs MFnertiel \ Oa�e (manN. tlaY. Y��
F�ient address of applicanl (number and s4ee7. afy. state ari0 LP ooda)
5" 9 S. �arr� Lav�e PriYlcs�o�.,�- ��l�-
Person aulhrn¢atl bY dury ezecutcW Power of Attarrey w by IC 61.1-1 -.OZ 7
Address oF aWtv¢ed pevw+ (num6er and s4ce1. rdy, state, aiM LP mde)
Date (rtimfh. tlay, yea�