HomeMy WebLinkAboutMortgage_Envision Financial Partners LLC.+°"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
_ FOR DEDUCTION FROM ASSESSED VAL�N
- State Form 43709 (R8 / 2U7)
S y�� 1 Presmbetl by Departmenl of Lacal Govemment Finaixe / �
INSTRUCTIONS: � ile a�l(
To 6e filed in person w by mad wrfh the CountyAudifoi o/ fhe county where fhe propeity is located.
Fd'mg Dates: 7) Real Property: Dunng the 12 months be/ore June f1 of the year the deduc6on is to be eRectj,y�py q q �(�� 8
2) Mobile Homes assessed under IC 6-L 1-7: Befween January 15 and March 2 of the year fhe'b�dLc6Un f� t�de e8ec6ve.
See reverse side /w additional insWctions ard qualificafions. �_ _,
Key number / lega
a6-�q- g- 3D3-
of re� papaly as d Mamh 1, aa2(U ypr
diffaeM Ihan Utal of applicanl, iMipte below:
of mortgagee or cantracl seller
Address of mortgagee m mnlract
Name of
GIBSON COUNTY A
RBmN
• IOT' VoCb
)e / ConUact udabtedness unpaid as of March 1, Is
mber aM streeG� LP cade)
of mortga9e �
Address of assgnee (nwrr6e`erM sUeeG dty, slate. and LPOOtle)
Does applicant o�tt� praperty in am/ dher If � �
counry in Indiana? ' V z•. ,.
❑re5 ❑r,o ; Drawcr \TO:�� ........
i � ,
\ , � •� • • BC
dion app�oved in Ure amount of: �' C `al I�d �7 �. . . � • � • • • . •
� ,�QT. �- �a7,�
zo O zo y<,c� zo '_ � ��_ � ��
Caunry
spouse, intlicate with whom.
« eyuitawe amen
❑Yes ❑ No
Is �he poperty in question:
❑ Real Property ❑ Mobile Home QC 67.
zo
Date
6een requested on propeny
❑ Yes ❑ No
zo _
I/ We certify under the penalty of pe�ury that the above and foregoing infortnalion is We and correU and that Ne applinnts was I were a resident of
(Gdiana and owner of the aforementiqqed property on March 1, 20 �
stafe.
ny d„y
f
Address of aullror¢etl persan (number aM s4eel, aty, slafe, aiM ZIP code)
Date (rteonfh. OaY Y��
(manfh. daY. Y��