HomeMy WebLinkAboutMortgage_Mayfield^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE Coun Township Year
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: FOR DEDUCTION FROM ASSESSED VA�� �
• Stale Form 43709 (R71 / 6-09)
�' y,. � Prewibed by Department of loml Govemmera Finance l.
- File Mark
INSTRUCTIONS: AUG O 9 20�� F«,�,ru�e�u,:
To be filed in person o� by mail wifh the CountyAuditor or Counry Recorder o/ the coum}� where tne pioperty is located.
Filing Dates: 1f Real Pmperty: Must file during the year for which tha deducfion is �' Counry Auditnr
2) Mo6i7e / Manufactured Homes rrot assessed as Real Property.� t eNe (12J months ❑ ry
6efae March 31 of each year fhe deduction is mtght Coun Recorder
Sae�eversesideforaddi6onalinstruclionsarMqualifications. GIBSONCOUNTYAUDITOR
MD�W�ili9�rormnvadbuyer-seeresvigprtsmreverse5�'1e) _ _ . i. /
�e�a��nyasa
1, NmV year
W�Idi 6 �1IS I �IPl PSMI 5�1318 Oi Y1�HESi�
on �emrd a d'Rluent Nan Ihat ot apP�4 hbirate below.
a
r -Q� /•a -
udebteEr�s unpaid az d Morig e I G
r date of aDpGc
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�fOM1E� WI(1150RIfIX12
se0er (numbe� end snee4 city. state. aM LP
Name ol assignee or oNer owner or holder M mwtgage
rna�s o� asvgnee �numoer em suee4 �y. s+aie, ana ur coae�
any oUer � If yes. what
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I I We cert'rfy under ihe penalry of
owner I contrad buyer of Ne afo�
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couNn nu�
Yes L� No
Is Ne property in question: MnuaM AssesseJ
�al Property ❑ Armually Pssessed
M1bhile Home (IC 61.
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2o I 2o I zo
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that Ihe above antl foregoing infwmalion is We and cortec[ and ihat the applipnt is a resident of IrMiana arW
ned property on da[e applintion is filed. � "� ��
� Date (monN, day, yve�
�'uA resident ot apq'ram (numbef ahtl sLeef state, aM LP oode) i+
.�3�G., aoo S �,�e�,� �,� ���� 6
Pason authoraed �y tluty esewteE Power of Atiorney w by IC 61.1-12-0.7
s�a�e.
. I Date (rtronN. QaY, Yea� .
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