HomeMy WebLinkAboutMortgage_Graper"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ • FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R71 / 6-09)
�' ` PraaiEeG by DepaRmeM of Local Govemment Fnance
�µ File Ma
STRUCTIONS:
To 6e filed in person or by mail wifh the CountyAuditor or Caunry Recorder o/the county where the pmperry is located. �
Fiting Dates: i) Real Pmperty: Must file tlurrng the yrear fi� which the deduction is sought. n Auditnr
2) Mobde / Manufactured Homes not assessed as Real Property: Mus! file dunng the tweNe (12) months �-� a ry
betoie March 31 o/each year Ne deduction is sought C un ecorder
See reverse side !or additional instniclions and qualifica�ions. G IBSON COU NTY AU DITOR
Appfiwnt(owne,[�cantradbuyer-seeiesbicOwwmreverseside) _ _ �
i- \ KeY mah6er / legal Cesaiptirn
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I vaWe af real7cpenY at W Mor(qage / Contraa u
amvrtYm Mamhl,a�rtentyear
C?: :
Name
seller
AEdrea W mort9a9ee y mntraa se�er (numbrsend stree4 �+b. sta�, aM LP code)
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Name of assi�nee o� other owner w holEer of mortgage
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Deduction approved in Ne artnum ot
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Si9rature d CamN Audiiw
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I I We certify under ihe penalry of perjury tliat the above aru
amer I contract buyer of the aforementioned property on d+
rc aw�d wim mmeone
Record nwnba Pag n
�b�% 0��� 0
atirn inEebtedrress unPaid as d � aPd���e avmM
�es n No
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hlodle Flort�e fIC 61.
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(Of d1I1M1� )'P2h
COUNTYAUDROR
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Card NO. .....�.7.�.z.......
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o�¢eO Dy duty exeartetl Power af Aitomey or Cy IC 67.1-12-0.7
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ant is a resident of Indiana arcl
Date (nmM, day, yae�)
Date (monlh. daY• yaa�.