HomeMy WebLinkAboutMortgage_Lindy"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS o n Tqwnship Year
:�_ _. FOR DEDUCTION FROM ASSESSED VALUATION �•
• Sta[e Form G3709 (R71 / 6-09) �
�' Presaibed by DepartmeM of LoW Govemmenl Frence �
w File Mark
lNSTRUCTIONS: U t �
To be filed in person w by mail with the CountyAuditw or Counry Reco�der o/ the counry whe2 the pioperty is located. �
Fifirg Dates: 1 J Real Property: Must file dunrn� Ne year for which the deduclion is soughL � Counry Auditor
2) Mo6de / ManufaUuied Hanes not assessed as Real P�opeRy Must file dunng [he fwelve (12) rtanths�
before March 31 ot each year the deduction is sought. / Counry Recorder
GIBSON CO
See 2verse side foraddrtionel insVUCUons arM quelificafions. DITOR
AppGCaN (yba�nd caritraC buyat- see �gsficDOns m revarse sida)
Oistrcl Keynumber/legal ption
,T�.� � (o-U .5 ', � - °yL� O "�b /. /
ed vahx U real poperty az ot Mortgage/ Contract intlebleCness unpaid az of
I. a�rt yrar Ma�U 1. wrrent year
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someorie
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Add�ess of mortgagce or mntrad se0er (number aM stree4 �y. srafe. arM ZIP code)
Name of assignee w oNr1 owner or hdder o( mort9� . • • • • . • • /•`� O•�• • �.%. • • • • • •O l� � � � �
" / V �
Does eppliiant own properry In any olner
munryinlnd'mna? [
❑ Yes
� _
DeducGOn appiwud in tlfe anwN of.
zo_ �
sy�n� m c�ry a,erco�
518IC� E
...:._..Q./.o.� .�i� �i�.\1�.IQ
I No
/�% �' . ...'..._6U��TYAUDiTOR '
�—T— Zo �
Remrtl number Pape numbu
aU/U ,J��
�.btedness im7aid az d Is Me eGP��t the sok
kgal w M�+��ble ame(?
❑ Yes ❑ No
spouse, iMicate riN wiwm
Is �he properry in puestion: MnueOy Atse55eE
� �P��Y ❑ M�U3II�/ nS5E55C�
n+oak r� nc 6�.�-�
Has this tletluUion Eeen ieQuesteE m prope+ty
kr artent Year! � Yes ❑ �
r
�_ �_
o�� �,�,ar�. ear. r��
I I We certify ulWirer the penatty of perjury that Ne above arW foregoing infortnalion is true and mrtecl arM that ihe applirant is a resitlent o! Irdiana ard
owner I contracl buyer of the aforemerrtioned property on date applicauon is filed.
and
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o( a�MaaeO percon (number aM sbee; riry, state, aM ZIP cade)
H 7G �0
Date (monfh, daY,