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aNj--.�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
,a ._.. 1 FOR DEDUCTION FROM ASSESSED VALUATION
°� � SUte Form d3709 (R71 / 6-09) I I
-� Presaibed by Department of LoW Govemmem Finance
INSTRUCTIONS:
To be filed in person oi by mail. +P(P'�)`''Wn ��
Filing Dates: iJ Real Property: Must be complefed and dafed in fhe calendar year7or which fhe deduction is soughL ��� � `� ��
Must be liled with fhe CountyAUditor or Counry Recorder ol fhe county where the property is located Counry Auditor
on or be�ore January 5 0l fhe immediafely succeeding calendaryeac ��� � Recorder
2) Mobile /Manulacfuretl Homes not assessed as Real PropeRy: Musf �le wifh the CountyAUdifor o/fhe
county where fhe property is lowfetl dunng (he rtvelve (72) months belora March 31 o7each year th
detluc�ion is sought - �IBSON COUNTY AUDITOR
See raverse sida for additional inshuctions and quali�cafions.
.4pptiwm (avner or cont`au buyer - see resMCtons m reverse vde)
BRIAN N MORGAN AND IRIS A MORGAN
Taurg Disirict
FT BRANCH
Auessed vaWa U real property as
March 1,airtantyear
125,300
I/ no, what is his I �er ezaci share
Kay numDer I legal E¢suiption
2G 19-19-203-001249-026
If name m rewN is di°ereni Nan Nat ot appGcani. indiwte bebvr.
JOHN A BERLIN AND RUBY R BERLIN
year
Nama ol mortgagee or mnVact seDer
HERITAGE FEDERAL CREDIT UNION
Adtlress ol rtqrtgagee w mnVact seller (num6er arM ifreet. ciry, sfafe,
5388 OLD STATE HVJY 66 NEWBURGH IN
Name ol assignee or oNer owner w holtler oi mortgaga
AdEress ol auynee (number and s[reet dry. alate, arM ZIP catle)
Daes applifant awn pmperty in any oNer I/ yes, what m�
wunry in Ineura? �.. �_.
as
dale
� t 30, t 50
I/ owned wiN sameone oNer Nan
�
I legal or equirade owner7
❑/ Yes ❑ No
inGiwta wiN whom
�foperty in question: MnuaCy Assessetl
�1 Properry ❑ MnuallyASSess�W
i �aen requeste0 on propeM1y
_ _.�� yeaR
n Yes n No
COUNTY AUDITOR
Oetluction apyv+eG in Uie amount oY.
20 20 20 20 20 20 20
IS'gnaWre of Counry Auairor — Counry Date (mmN, Cay, year)
I1/ We ceNfy under the penalry perjury Iha above and foregoing infortnation is Irue antl cortect and that the applicant is a resident ot Indiana and
vaner / convact buyer of the aforementione roperty on date appliraGon is filed.
I Signaw (owneFSlWlname) Date (monlh. day, yea�
osmno�z
uG resMmt atltlrczs o pplirant (number and sLeeG dry, sfaro, and ZIP cade)
7848 S 70 E FT. BRFVJCH IN 47648
Person auNOrizeC by Guly ezeryted Power ol Attomey or by IC 6-1.1-12-0.7 Date (monlh. day. yea�
�Addresso/auUar¢edperson (numberentlslreet,city,sfafe,andZlPCOde)