HomeMy WebLinkAboutMortgage_Bratcher'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
.,.__ .
� FOR DEDUCTION FROM ASSESSED VALUATION
� Slate Fortn 43709IR71 / fi09)
, ? Presaibetl by DepartrneM af Loral Govemmerrt Firw�ce
� File Ma
�STRUCTIONS: O
To be lled in person or by mail wiUi the CountyAUditor or Counry Recorder of the counry where the property is located. o d
Filmg Dates: 1 J Real Property: Must file durirq the year lor which the deduclion is sought. unty Auditor
2) Mobde / Manufactured Homes rrot assessed as Real Property Must file duriry fhe hveNe (12) months C� �
q/ before March 31 of each year tAe deduction is sought. ry Recorder
Seereversesideloradditionalinstrucwnsandqualifications. GIBSON OUNTYqlIDI7nR
i 2al P�oDertY as ot
Y�
if ro, what's his / her eraG sl�are of intsesll
If rame on mmd'a
Name aF rtwrtga9ee or mntrarl
'�1-1 'Cx> V
Mortgage / Contraa'udebted�ress unVai7 as W Mort9a9e / Contra�Y @Mebtetlnrss unPaid as d
Ma�th 1. wrteM Y� date of aPP��b^
� ab.�
If awred with sameo�re oNer than sGa+�. inA"rcate wiih i
(number aM shee; ciry, stete. arN ZIP code)
of assignee w other awner or hdder o1 mortgage
ACdress of assignee (num6er arM shee4 �y, sbte.
DpES a(plifaM o.vn P�PeNY
muMy in IMena? r
�m�a��of
If yes. whal munt�R
20 � n) � 20
of Counly Autlitor
4Ma� Tantg D¢Na�
)UNTYAUDROR
zo zo
Page numbe�
P�PertY m Guestian: Mnually Assessed
�I ProP�Y � �Y �
Drawer \'O..o.�.Q.�� ^
No
C��'d NO. ..t�..'.o...........
�S �8'
�_ � p-
Dale (rtpnfh. daY Y��
I/ We certiFy under the penalty of perjury that the above arW foregoing infortnation is W e and cortect arW Nat ihe appl&ant is a resident of Indiana aM
owner / contract buyer af Ne aforementioned property m date applualion is filed.
v�anue IounerS hN irertrel Date (rtwRA. deY Yaa�)
Pelsan aWroiaetl Ey
SUeef. afy, state. 3M ZIP mtle) o
[.ti. �`.t� 9.2tifLf7 .riZ% �7/i
�y o. cy ic ui.i-�z-0.�
of a�MOrrzed persm (numberantl sbee4 dry. state. aM