HomeMy WebLinkAboutMortgage_Stodghill (3)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
:._—.
FOR DEDUCTION FROM ASSESSED VAL�l� ��
• S�ate Fortn d3709 (R77 / 6-09) �
♦ I PresaiCeG M DePa�rd o( LnW Gwemment F�ance
File Mark
�srRUCnoNS: DEC 3 0 2�11
6e filed in person of by mail wiN the CountyAuditor or Counry Recorder o7 tAe counry where e property is located.
Filirg Dates: i) Real Pmperry: Must fde durirg Ne year /or which the deduction�s so 7
2) Mo6ile / Manulactured Homes rrof assessed as Real Property �sffi e unq Ive (72) monfhs
6efore Maich 31 of each year the deduction is soughf. v
S�versesideforadditionalinstryctionsandqualifications. GIBSON COUNTY AUDITOR
� ra4ie u rea yopel.y a ar Mortgage / traa inEebteCness
A1atr�h 1, arruil yrlr Mar� 1. n���
i
I( ro. what is his / her erafl sha�e W interesi? ���—
It nartre m recprC ig yrt¢rent ihan that of app9pN, uWicale Debw:
r+ame o�,norcgagee « conrau seuer /�
1 \/l
--""-°^� ��miher end sbee4 �ty. s+ate. ard ZIP code
- � �
Dra«�er NO..v?.Q.��.�.....
Card NO. ....9�D......... :���
I COU
Deduclion app�wed in tlre amount of:
20 20 20 20
I/ We certy wWer the
`�_�'7 Vl. �
Person auNO�rzetl by Culy
Dg�
y o rjury NtAt the above aM (or c
a me � pro rty on date
/
imbe arid ShBe( Crty, sYdte. and Z/IP oode)
A.�..rl
Power ol Attomey m by IL 61.1-12-0J
rer aM stree4 c% sb(e, antl LP mde)
Fam fded w�h:
.ounry Auditnr
❑ County Recorder
�l.��L/' 7 7 � al.� Rerord n i� � � P�e n! �
3-
unpaid as ot Mortgage / ContracY c�debte0ness unpai0 as of Is ihe apFdxanl Ne sde
Cate o( aGP�tion legal w ewitade o�m�M
� ❑ Yes ❑ No
If bwnad with someorie other Ihan spouse, indirate with wtnm
Is Ihe properly in puestion: MnuaM Pssesxd
❑ Real Properry ❑ Nmualy Assessed
r�oa� r� nc �
I W�a� Taring Disinfl? I Has Ihis deduGiai been reQUested on property
for arten� yea/.�
❑ Yes ❑ No
YAUDROR
�
20 20 20
Caunry �ate (mwvh, daY• Yea�
rtnatlon is true and cortecl arM Nat the applicant is a resident of Indiana arW
is filed.
Date (monfh. day. YBah
Dale (monfh. tl3Y le�