HomeMy WebLinkAboutMortgage_Fulcher.r °'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year .
FOR DEDUCTION FROM ASSESSED VALUATION
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S � �bed by Departrtrenl d Locel Govemmerrt Fi�nce
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INSTRUCTIONS: I
To be (led in person or by mad with Uie CourrtyAuditor o/ the county wheie the property is bcated.
Fding Dafes: 1 J Real Properly.� Dunng fhe 12 rtronths be/ore June if of ftre year the deducbon is fo be elfecbve. A P R 1 4 z��9
2) Mobile Homes assessed urtder IC 6-1.1-7: Behveen January 15 end Marcf� 2 0/ Me year Ma deducfion is to be eflecLve.
See reverse side for ad�tional ins6ucSons and qualificafions.
npp�iraM(ame mnva buye
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Assessed vdue o( real property as
reverse sde)
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anrenl Y� � /1 _ �
eud share a('uMrest7
If name m record is d"MeraM than fhal d
Name of mmtgagee or mNacl
mongagee a wntrad seller (ntanberand 56dgt. dt}t s1ale. arnd LP cade)
signee or dher oaner a hdder d matpage
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Does applicaN wm PrapertY ir
courdy in Ind'are7
❑ Yes
�ction appmved in ihe arna
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someona
Tarin9 D'a4i�.tT -'
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'OR
20 _ 20 _
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1 I We certify under the penalry of perjury that ihe above and foregoing infomiation is true and corted a
Indiana and owner of the aforementimed property on March 1, 20 _
iderrt address ot applicaN (n`wnbe` ena street a1Y. state. aM LP cotla)
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Person aWhor¢ed bv d�N �eMed Poaer d Adort�ey or by IC 61.1-12-.07
slreet dfy. sWfe, arM ZIP aode)
GIBSON COUNTY auwiurs
Remrdrwmber Pagenumbm
09 /3a.� _
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❑Yes ❑No
�ouse, indiwta with wMm.
e praperty in quesUm:
Real HvceAV ❑ Modle Home OC G7.
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ted on praperty
'es � No
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