HomeMy WebLinkAboutMortgage_Murray'°n STATEMENT OF MORTGAGE OR CONTRACT INDE DR1E�S Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
r � Stale Form 43709 (R71 / Ca09) ��J
�,,,, ° Piesaibed by Departmern of L.aml Gwemmenl Ftrnnce
-� File Mark
�vsrRUCnoNS: EC 2 9 2011
!0 6e filed in person or by mail wifh the CountyAuditw or Counry Recorder o/ tfie county wheLe the� 's located. F� ���
Fding Dates: 7) Real PropeRy: Must file dunrg Ne year Por which lha deduction is sought. � riri, �� q�d��
2) Mobde /Manulactured Homes not assessed as Real Pioperty: Musf hie dunrg ttie twe 1 onfhs i�� ry
6etore March 31 o/each yearNe deduction is sought. G�BSON COUNTY � �nty Recorder
AUDITOR
See 2verse side lor addifional instruclions and qualifications.
Ta�drg
Aaetsed vabie d real propety as ot
A1amh 1, amrnt year
Key ra�mber / legal de
Mwtgage /
Martli 1, a
If M. �Mat 5 �rs / her e�d share of interest?
11 name m recoid is EiRerent than that o! appGcant, uWir�ate bebw.
Name of mortgagee or cmvarl se0er�
3
AEaress W mortgagee or mntraa uuer (numbei and stree4 db, sfate, an0
Name of assignee w dher owner or hdder of rtqrtga9e
AEtlress of assignee (n�mber and shee4 �Y. �te, arM Z/P code)
Does applMant pm poperty in any oUer It yes, whal couny
counry in Indiana?
❑ Yes ❑ No
Or�utlion in ihe amount of:
20 20 _ 20
Signawre W CamN Auditw
az
Recard numba
az
w epuftable owneR
❑ Yes ❑ No
If wmed with somearie aher W n spouse, iMirate with ulwm
Is the property in Qurstian: MnuaDy Assessetl
❑ R� �ro O �N �
.�1-atirerl\`Q._�Q(� `
C. • ... .. ..
a,.d ,,;� , � yc�a
� �9b,q.t�.
COUNTYAUOROR
20 _ � 20
Caunry
en reQUesteG m propcty
p� � ❑ Yes ❑ �
L..
20 20
oa� (�ro�vn. aay. rea�
I/ We cerlify under Ne penalry of perjury tl�at the above and toregoing infortnalion is We and cortect and Iha[ ihe applipnt is a resident of Indiana and
owner! contracl buyer of the a(orementioned property on date application is filed.
�namre�,gner: rw �anrey _ � oate pno�m. aar. r'�e�
of app�rant
anC ZIP mde)
PdCmss M author¢ed person (number ard strret. pry. sfate. aM LPmtle)