HomeMy WebLinkAboutMortgage_Cowling^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__, � FOR DEDUCTION FROM ASSESSED VALUATION
. .• Slate Fortn 43709 (R71 / 609)
\ ! p��p� py Departmenl of LoW Govemmenl Fl�ance
�"" Fle Mark
srnucnoNS:
To be filed in person w by maii with Ne CounryAuditor or Counry Recorder o� the counry where the property is located.
Fiiing Dates: 7) Real Pmperty: Musf file dunig Me year for which the deduction is sought. �„ ry Auditor
2J Mo6Be / Manufactured Hortres rrot assessed as Real Prtiperty Mus! fife during the fwefve (72) monfhs
6efore March 31 0/ each year the deduction is sought " ecorder
See reverse side (or addiWnal instructions arM qualifications. G I BSON COU NTY AUD ITOR
Aocdrcambwnarmcontrdct6uyrer-seercsbiraonsmreyerseside) _ �
T2v��
Asessed rdu
A7art3� t.nmr
u rio. wnat a r
az ol
share of interest?
� % � � � � �U y � Pi
Mortpage ! Contraa inde6ted�ress unpaitl
March 1. a�rtent year
(ame m recoN is Qftera�t lhan �hat of aDpGrant.
Name of rmrt9a9ee or
�
Address of rrort9a9ee w contract seDer (nunih� and sfree4 �RY. slate. aM Z/P code)
Name of assi9nee w oNer owner ar naaer ot matga9e
�t assgnee (numDer ana sueeC ary, smie, aiw cm cme�
ru t9-3-io � �-5 �
limnt own praperty in any oWer If yes, what munl�/.�
Ind'ana? r-i . _ r� ..
20 _
amount
� -a z-6 ��%� P��Oo �
tgage I CanRaG uMebtetlness ispaid as of Ls Ne aPP�� Ihe sde
; of aPPlitation �egal or epuitade v.mM
� D O � ❑ Yes ❑ No
sameona dher than soouse. iMirate wtth Miwrn
Wha� Tav�9 �a�iclT
20 _ I �1 I ZD _ I p
I5 p¢rty in 9ue5Gon: MnuaM �sessed
Real Rovenv ❑ Mnua�N Psse��
Mohle Hane (IC 61.
C.Ow �f►� G� Q.i 1� �J E M
I 1' LQ U� 1
rS��
Date (manth, daY• Y��
i��]
I I We certify under ihe penalry �perjury Nat Dove and foregoing infortnatlan is We an0 cortect and that ihe applinnt is a resident of Indiara aM
owner / mntraG buyer of the a(o2mentioned rty on date applicatlon is filed.
� Sign re(owner`s fiAname . ' Date (nw+tb. daY. YeaA
Full {', ent etltlress o appficant (numDer z' t, tity�,s1�� te, r��(�Z�IP�c�o�tle � �,6 ��
J0� S' ��� Jl- • %�d'w//I`ti�
Person auUrorrsed E�/ tluty executeE Power M Attorney w by IC 61.1-12-0.7 �� (�N. �l: l��
Address of aulhor'veA persm (numDer aM sbeeL cdy, state. eM LP code) .