HomeMy WebLinkAboutMortgage_Strickland� STATEMENT OF MORTGAGE OR CONTRACT INDE
__ FOR DEDUCTION FROM ASSESSED VALUATION
Sta[e Fortn C3709 (R71 / 6-09)
,,,,, � PresoiEed by DepaftmeM of Lo� Govemrtrent Firence �
C n T i ear
wsrnucnoNS:
MAYF'� Ma`�010
Form Ned with:
To be filed in person w 6y mail wdh Ihe CountyAUditor or Counry Recorder of the counry where the property is lacated.
Filing Da[es: 1J Real Pmperry: Must file dunrg the yrear /or which the deductlon is sought q�d���
2) Mo6de /ManufaUUred Homes rat assessed as Real Property Mus! file dunng the twelve (12) rtwnths ty
before March 37 o/eadr yeurthe deduction is sought. � GIBSON CO TY AUDITOe��
See /everse side tor additional instructbns end quelificatnons.
IAppGmnt( arcontrarl6uyer-see m side)
'i T'ng Distria / legal desmption RecorO n mber P e numbu
' L� 6- -/o - o. 3S b 55
Aaessed ralue d 2a1 V W�Y es of Mortpage / ContraG intlebtedn�s unpaid as d Morigage I ContraU uWe6tedness imPaid as d As Ne e0 t Me sde
Mert3i 1. arian yw Mart3� 1, wrtent year Eata t BPP,���f� legal a epuibNe amell
1 �e���L�v ❑Yes ❑ No
It no, what is ha I tcer esact sha�e
u
irortgagee «m,aaa seaer
mnbaG se0er (numDer end sLee;
Name of asignee w athe� avmer w
AdCress of assignce (number aM street
� WoO�Y
mw�age
S18te, enO ZIP a
I( yes,
No
If ownad with wrneone oNer fhan spouse.
_ _
__� Is Cie property in G��: MiwaMA�wcsed
Dra���c►• \'O...G?��.0....... 6
C�t'CI \�. ... � �`^'........
(�9, 3(� D, uv
Has Iha tledumm Oeen re9uestetl m piopaty
tar wnent YPaR ❑ Yes
❑ No
COUNTYAUDROR
DeEuc9on approved in the amount aE
20 _ 20 2Q _ 20 _ 20 _ 20 _ 20 _
SignaLae d Camb Auditor Cau�N Date (monfh. daY• Y��)
I/ We ceNfy urWer the penatty ot perjury Mat the above arW foregoing intormation is true and corteU arM Nat the applipnt is a resident of Indiana antl
owner I contraa Duyer ot the aforementioned property on date application is filed. �� -� --�� �
oxnefs +iem Date (monfh. daY. Y�A
. levde aEd`ess ot appfrant (num0er ard sheet �ry �te. end ZIP oode)
a0 S. 4;Nta/n Sf r�wch 7'/
auCa�ed by OWY e�cacuted Power of AttomeY or Cy IC 61.7-12 .7 Qate (monM. deY. 3��
P4dress af autlia'¢Ed person (num0er arnd stroe4 �: stafe. end ZIP oode) .
.- �.1 " ' '" _ _ '