HomeMy WebLinkAboutMortgage_Craig.""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
._ FOR DEDUCTION FROM ASSESSED VALUATION
Stala Fnm 43709 (R10 717-08)
� wo � Prasrn"6ed by Departrnent of Loc� Govemmerd Firence
INSTRUCl10NS:
roeer,ream�.5o„oray�e�mnreca„�rya„e;mrau,a�.�rywna,�waa�vB�r�ro�rea. JUN 1 0 Z009
tilirg Deles: iJ Real Property: Must file dunng the yeer /w which the dedudion is sa+ght.
2) Mo6de / Manulactuled Homes nU assesse0 as Real Properry: Mus1 file dunrq the hveNe (12J mmths 6e7ae March 31 0! each yee�
the dedudion is sought. q
See reverse sitle lar addd"mna! irtsfrudions and qualifications �%P N�
App&ant(owneformNracfMA'm-seo�yms mro�.mcesEe)
/"w..� M� n. /f n� w. GIBSON COUNTV AUtlIfi�R
t - .
AssesseEValuaofiealP�O�basd �qap e/LW`adrti
Marti� 1. aurenl yaar M�a�ch 1. eN year
tl ro. W�af is hs / her eutl share d i�resft
Y rame m temfd's d�eranl ihan Ih� of app&an�. ui0imte bebw.
Name d matgagee a wntraG seller /] /�
unpaid as d I Mat
dale
Pddress d`mfigagea a mrtraU seCer (mmherand sfmot �a!—Y. sFai4 antl ZW codo)
Name d assignea or o9�s wvr�r ar Mder d mort9a8a
MEress d assignee (numDw and stroaf, dry, sA4�, aiM LP m0o)
oo�ap�,�,�v��a� rcY�.,�,�,�a,n
� � immrez
❑ Y� o No
zo �
I/
ez���;�
Z��
'�iJ
s
if rnmed with sameone olher lhan sPa+�. mdirale wifh whan
a
Yes LI No
IS Me propBRy in Quesiion: AnnwOy Assassed
� Real Property Q Mnually Assessea
Mo6ile tiort�e (IC 61.
� ����«��,� �ioQ..q.-...�.� 3 9 ��M
❑
nu Card NO . ............ �
LV _ � _
Date (mvuh, tlaY. Y�
_o
untlg Ne penalry df perjury ihat Ne abwe arb tmegdng ciformation is true aM correfl and ihat the applicant is a resident of Indana and
ad buyer a( the aforementione� property qn date applintion is filed.
s fiAname) � f"') Date (monM. tlaY• Y��I
AOEressdauthorizadperson (nunbo`antlsnoot,rity,sbte.anOLPcado)