HomeMy WebLinkAboutMortgage_Lindauer^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
_, FOR DEDUCTION FROM ASSESSED VALUATION
• State Fofm 43709 (R77 / 6-09)
�,�„ j Presaihed by DepartmeM of Lod Govemmerrt Firance
File Mark
�sTRUCnoNS:
b be filed in person w by mail with Ihe CountyAWitw or County Recorder o! fhe counry where the property is located.
Filing Dates: 7� Real Pmperty, Must file dunng fhe year for which the deduction is sought. ry Auditnr
2) Mo6i7e / Manufacmred Homes rat assessed as Real PropeRy Must h7e dunng the hveNe (12J months �❑
befoia Marth 37 0( each year the deduction is sought. n ecorder
SeereversesidelaaddiLOnalinstructionsandqualifications. GIBSO NTYAUDITOR
AooGnnt (awrer or mnvact 6uver_ see re5tir7ians rn reverse sidel 1
Asses.sed ratue d real qoperty az of
Ale`U 1, aamn `pr
�
Ii ro. what 5 his / her esaG share o
ir � o� re�d o artre�� uw� u
r / legal desaiptim
� 9-/�.�3-cao 6
Mortgage / Cantraa irdebtedness unpaid as of
Mard� i. arSe�rt year ,
'uMitate bebw.
tJZm¢ of mwtgagce or oonttarl seller y/�
./
Address of martgagee w contracf se�er (num6er and stree4 dh, ��e. aM ZIP
��o,���
AOCress of azsignce (wmber aM al
ooes epd�om own woc�r �� a�y �
tounryinlnEana? ❑ Ye5
pr�uctim apprwed rt� ttce amount ot
mortgage
slate,arc
GC7
Recortl numbu Page numbrr
O o // 35
Iga9e / Contrarl'v�deb edness unpaid as d Is Me apprmant Me sale
r of aPP�m� �e9a� or eWitade oh*�eY.�
❑ Yes ❑ No
someorie other than spouse. iMipte w%h wMm
Is Me VoPertY in Guestion: MMia%ASSessetl
ea�Pmvertv ❑.�vmuanywssessed
Mo6ile Flarie QC G7.1-�
p��� u'�pAGE(t —
���.����m ,��T�� 1135a9
�
� No
20 20 20 20 20 20 _ 20
�faNre ot CMmry Audiior CouMy Date (rtpnfh. AaY, Y'�a�
I/ We certify under fhe penalry of perjury that the above and (oregoing infortnaUOn is Vue and cortect arM that the applinnt is a resi0ent of IrWiana antl
owner / wntrad buyer ot the aforementioned property on date applira0on is filed.
�fut63i (awner's MI namel i A /1 Data (rtmN. daY•Yeah
FWI resident eEtlr¢s of appluanl (numbar ard bbee[, rily, state, antl ZIP Oo[
G YOY E. S r,�!}/nJ Sf, f�R i
Person auNOriud Oy dWy erecuted Pvwer of Attm�ey w by IC 6t.7-12-0.7
Pddress of auNa'¢ed prsson (numberaM snee4 �'. sbte, and Z!P code)