HomeMy WebLinkAboutMortgage_Nurrenbern (2).���� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
2,, ., FOR DEDUCTION FROM ASSESSED VALUATION
Sfale Fortn 43709 (R8 ! 2-07)
�''„ 1 Presaibetl by Deparlment of Local Govemment Fi�nce
n Township Year
�
INSTRUCTIONS:
DEC IF� �
To be (led in person or by mai! wdh the CountyAuditor o/ the county whera the property is located. -
Filrng Dates: i) Real Property.� During fhe 72 months be/ae June 17 0/ the year the deducUon is to be eflec6ve.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 0/ Bre year the de�
See reverse side (a additional insWctrons and qualifications. �1
Applican� (owner w mnVacY
a rea� po�ny ��t c�ro� i. a„�,� y��
enacl
on recortl is d'Aferent Ihan �hat ot applicant, indicate balow:
Name of rtartgagee or contract seller
AOdress of moAgagce w mnUact sell
Name of assi9nee a ather o.vner w h
GIBSON
-lS = --(o�'�'00 . aab -0 �,6 0 � 5 �f 5'
�e / Contrad indebtedness unpaid as of March 1, Is the appli�nt the sole legal w equitade ameR
year /�/���
i l_�f/C/C J ❑Yes ❑ No
sVeef. tity, sfafe,
Address of assignee (num6er a�M atreef, dty, sfafe, eiM IIP code)
Does aPP�icanl awn property in arry oihm
couMy in Intliana?.. . — _ _--
o�, ���:,,,���� �o�Q���� � 1�s��
Card \O . ............
.........
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Sg� a� 3 0, i s-o.
couNrrAUOROa
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Couny
someone dher lhan spouse,
ma a��m
I Real Prop
�Itict? Has lhis tleduction
tor wnent yeaR
zo _ zo _
Date (ma
❑ Mobile Home pC 61.
�estetl on proparty
❑ Yes ❑ No
day,yee�
zo
1/ We certify under the penalty of perjury tliat the above and foregoing information is true and mrred and that the applinnts was I were a resident of
Indiana and owner oi the aforementioned property on March 1, 20
city. s78te. aiM ZlP m
\ I\ � 1 `
� w bv IC 61.1-12-.07
Atltlress of authoraed persm (number arrd sVeef. cdy. sfate, aM ZIP w0e)
Date (manth, OaY Y��
� ��
Dale (mmN. tlay, yea�