HomeMy WebLinkAboutMortgage_Arnett (2)"�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear ~
_, s FOR DEDUCTION FROM ASSESSED VALUATION
� � � State Fortn 43709 (R77 / 6-09) Y
, � P�gaibed 6y DepartmeM of Lxal GovemmeN Fl�ance ����
� File Mark
wsrRUCnoNS:
To be (led in person w by mail witA the CountyAuditor or County RecoNer o( the county whe2 fheR p� rry is located. Form Aed wiM:
Filirg Dates: 7) Real Property: Must file during Ne year for which the deduction is soilbAA� � 3 [� I I �,�Co�nry p,�dhnr
2) Mo6de / Manuladuled Homes rat assessed as Real PropeRy: Must Ne`�dumg tRe fweNe (12) months
6efore March 37 of each year the deducfion is sought ❑ Counry Recorder
c.�.
See reverse side tor addrfional inshuUions and qualifications.
nppraant(ownaror ^ I 0� O� M �� GIBSON COUNTY AUDITOR
� � 'I KeY �/ �gal descri�� �4-� S 3 0 3�o 00 . a��-o a�emrtl num
;ed ralue d mat papeny as o! MMOage / Contracc'udehtedn�sss unpaid as W Mw�qage I Cono-xt inEeMeeness unpaid as of
1, arrent year Mart3� 1, n�rtent yrar � Q'�1 Eate of appGcation
If no, what a his / her e�ct share o1 interest?
If name an tecord "a
rtqrtgagee «mntract u0er
mortgagee ar conaacf seuer (menbr� sre saeel, cilr. smte.
Nama of assignee w othu awner or hdder ot mortgage
AOCre I
�= DrawerNO....�0�•4....... —
munty
— Card NO. ..�.4.��.......... o�
��� ���(o45�csu =
x_ , ��_ � zo_ � 20
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I I We certify under Ne penalry
owner I contracl buyer of Ne a
Person
Wha, Tari�9 DisNd7
•s'�
spouse, i(Wrcate wiM whom
�
Yes U No
h the D�DPnY m puPSfiwr. MnuaM Assessee
❑ Real Roperty � � Mnually Assessed
Has
fm C
SteG m V�W�Y
Yes ❑ No
� I p
+0�01�Q1�,�.Q � � ��ry �. ��.O,�.L� ��. ��Co-03 �� �
that e ahove and (ore 'ng infortnation is We and cortect and ihal Ne applicant is a resident of IrWiana and
ne� property on date ap tian is filed.
of AttomeY w by IC 61. td 2-0]
person (number arM street �: s+ate,
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