HomeMy WebLinkAboutMortgage_Carter (6)^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
_ : FOR DEDUCTION FROM ASSESSED VALUATION
� State Form 43709 (R71 / 6-09)
�` P�ewibed by Department oT laal Govemment Friance
ie a
INSTRUCTIONS:
To be filed in person or by mai! witA the CountyAUdRw or Counry Recorder of the counry where the property is located. � U
Fifing Dates: 1) Real Pmperty: Must fi)e dunng the year (or which the deduction is soughG ��Counry Audimr
2J Mo6ile / Manufactured Homes not assessed as Real Properfy.' Must file dunng the hvelve (72) monfhs C. . C ry Recorder
6efore March 37 of each year the deduction is sought.
See reverse side tor additional instructions and qualifications. IBSON COUNTY AUDITOR
AppGpnt rorconved6uyer-see m verseside) '
T'rg OistriU Key num r/ legal desc�iption �� Remrd number Page num6es
o��o- /8- -ao�{-000. v7o- o�� �'78a-
vdW¢ d real prop¢rty as of Mortgage / Contract'udehtedness unpaid az M Mortgage / ContrafY indebtedness unpaid as of Is Ihe appfrant Ne sde
Marrh 7. nmmt year March i, arrent year dafe of aPPliqtbn p legal or equhaWe rnmM
5 p a- �O � ❑ Yes ❑ No
If ro, what is his / her exarl share of interest? It owried vriN someone dher ihan spouse, indirate w�h whom
If rume on remN is d�Rerent than Nat of aDW�� Ndipte below I ihe property in 9uestion: MnuaPY Atsessed
�F2ea1 ProPeRY ❑ ?!�^!!�Y �� . . ,.
'ame of rtrort�agee or mnbact seller �j �
Address of mortgagee w contracl seller (nu r aM stree4 ctty, state,
Name of assgnee w other awner or hdder of rtartga9e
ACCress of asy ee (n�mber and street �t sfafe, aM ZIP code)
`'/ ��� �
�
Ooes applimnt ovm yoperry in any oUer�
counryinlMiana? n .."_
oe
zo I zo
Sigrature of Co�mry Auditor
C . -�`.
I/ We certify under ihe penalry of rjc
er I contrad uyer of the aforemen
{ � s tlname)
X
uNOrrzed Dy duly en
of authwrzed persm
' — �_
�� G�R�SS a� /
Vmatl � a a ��a Y
:ouNn nuon
zo zo _ 20 _ 20
Counry . Date (march, daY. Y��
infortnation is We and cortec[ and that Ne applipn[ is a resident of Indiana arW
-,,,,��wnon is filed.
Date (morNi, day, y�a�
rmberand�sh^ee(, ity,state,andZlPOOtle)
�vi f—�• ��YQNC� '��
Power o(Anomey or by IC G7.742-07
xr and sveel, ciry. sbte, and ZIP code)
day, yea�