HomeMy WebLinkAboutMortgage_Haig^•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ . FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate Fortn A3709 (R71 / 609)
�' � Presaibed by �epartmenl of Laal Govemment Frence "
ile M rk
INSTRUCT70NS:
To 6e lled in person or 6y mail wiN [he CountyAUditor or County RecoNer o/ Ne county where the pmperty is locafed. F� @�y��7
Filing Dates: 1) Real Property Musf file dunng fhe year (or which Ute deduction is sought. D C� 1 p(��quditor
2) Mo6ile / Manufactured Homes not assessed as Real Property Must file dunng fhe twelve (72) months
before March 31 of each year Ne deduction is sought. ❑ Cou�b Recorder
See ieverse side !or additional instrucGOns and quatificafions.
noormm (owner or cwio-au bwu - see resniraa�s m re.erse side) • Al1DITOR
0
�<�. �t . %�a
gal drsaiption
-/ -/3 - y� � - oe
tgage ! Contraa inCebtedness unpaiC az ot
Ch 1. a,rtent year
Q Q � �
If ownad
name m 2co�d'a difterent Nan Nat of applkant, indirate bebw.
Name M rtnrtgagee or contract seller
neares� w � � �o-�,
owner
saee4 �'dl: sm�.
tlry, 5late, aM ZIP cotle)
GIBSON COUNTY
Remrtf number Page rwmCu
9-p�.� �ooq SY9
I legal w epuitable ovme(�
❑ Yes ❑ No
spouse -
a�b�
'�R s4-R 3
_ � Qf o� Br 0.n
�' � i Z�tih
_ � ����
Ooes epplimnt o:vn property in any other If yes. what muntyt Wtat Tad'g Distri`i? Has Na detluf]im Ecen requeste0 on propeny I
munryinln0iana? � Ye5 ❑ No forarrcntyeaR � �,� � No
ry