HomeMy WebLinkAboutMortgage_Knakmuhs-^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBT� n 7ownship Year
• FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate Form 43709 (R71 / 6-09)
S i Presrnbed by DeparimeM olloml GwemmeN Firams
NSTRUCTIONS: NOV 1 O 2��� Fle Mark
Fmn hled wiih:
To be filed in person w by maif with fhe Co�nryAUdrtw o� Counry Recorde� o/ the counry where the p[Dpe
Fil"rtg Dates: 1) Real Pmperty: Must file during Ne }rear (or which the deduclion is wughL `' ��' �Counry Audimr
2) Mo6�7e /Manufactuied Homes not assessed as Real Pruperly Must fi!e dunrq the twelve (12�
befom March 37 0/ each year the deductian is sought ❑ Caunry Remnder
GIBSON COUNTY AUDIT R
See reverse side lor addifional instnrctions and qualifirafions.
I MW�nt (owrer or ca
:�
✓ n..��i.l� �/ i V�%�lii-i�
Reco�tl �6qr Page
io3-oo/. �94-oa6 i
Pssessed va4ie drnal prnperty as of M�(p�ge / Contrati indebtednrs unPaid az U MMyage / CantraY cWebiedrress unPaid as o( Is Ne eGP�I lne sole
Marfh t. armrt yrar Mard� t, artent year data o/ eppBtation Iegal a equilade orwMll
a(��0� ❑Yes ❑No
If rw. what is Ais / her eza�2 share ol inir�t? If arrred wtth mmmne aNer ihan sPW�. indxate with wMm
If nazne m remrd s dPere�t Nan ihat of aPP�t trM�ate hebw: Is IM prope`ty in QuesGm: MnuaDy Assessed
❑ Real ProPenY � A"^�N�
� - r�oax r� nc ��.�-�
Name M mort9a9ee or mnVaG sWer
v / �
Addtess W mormaaee or wntract se�er (nwnber and stree4 �: s+afi. ar.
Name of assi9nee or other owner or holder of rtnrtgage
(number arM stree; city, slate, eM Z/P code)
�I I......
DI"81YCC \� .............
i ... T V.� �J......
Card 10.
Does eDWipnt wm property in any other If yes. whal munt '�� �"�) U i been requesteE m prapelty
munry in IMa�a? ❑ Yes ❑ No 1 _..
❑ Yes ❑ No