HomeMy WebLinkAboutMortgage_Thompson""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
:__ = FOR DEDUCTION FROM ASSESSED VALUATION
• Sta[e Fortn 63709 (R71 / 609)
,' Presaibed by OepaNnent ol Lool Gavemmenl Frenca
iI Mark
INSTRUCTIONS:
Fwm filed wiN:
To be filed in person w 6y mail with the CountyAUditor or County Recorder o/ the county whe�e the pmperty is locafed. O� p
Fil'mg Dates: i) Real Property: Musf file dunmJ the yrear Por which the deduction is sought ���i;Wn�Q{�tor
2J Mobile / Manufactured Homes rrot assessed as Real Pmperty Must file dunng the tweHe (12J months
before March 37 0/ each year the deduction is mught ❑ Counry Recorder
�.-,
See reverse side for addi�ional instructbns and qualifisations. a �+�"'
jAppG�ant(o rorwntraq6vyer- rss versaside) v
�. � �n _ . , s��Pl �% _ n n .n, GIBSON COUNTY AUDITOR
u - '. /! .J - +�ca' Y� o.� !
Asesed vdue d rral propeny a d Mortpage I Cantraa intlebteCness unpaid as of Mortgage I Convact mtlebteCrress �mpaid as d Is Ne apd�t the sde
Mamh 1, nrrent yPar March 1, wrtent ynar date of appGtation n•/�� � legal w equitade amefi
I ��� -/CJ�� ❑ Yes ❑ No
n 110. W�ld� 6 �16 i ilff BYdf15�IdfB O� YII�I� tt wmed with mmeorre ather ihan sPa+�, iMhate with �Nrom
tt'wrie m recad "s d�tterent than Nat W a7G�t trMirate bebw. I property in aursiion: MrwaOy Assctsed
Real Ptoperty � Amlually A�e�ed
Name of mortgagee or mnttacl sWer
�
�uandsvee4cifl:ss-"_—'_"._ -'. �
��e
I HamPsa�,1 ��
Mdass of assignce (num0er a�d stree; ciry, slete, aM ZIP catle�
Ooes eppfuant ovm property in eny oNer If yes, what �
munry in InOiana?
❑ Yes ❑ No
Dr�utlion apyoved in Ihe artpunl of:
20 20 20
09- 3i-�
COUNTY AUDITOR
20 20
Counry
s deduGion Eeen requested m proprlty
ent yeaR
❑ Yes ❑ No
20 20
Date (rtoNA. daY• YTa�)
i/ We certify under the penalty of perjury that the ahove and foregoing infortnalion is W e and mrtecl and thal Ne applicant is a resident of Indiana antl
owner I mntract 6uyer of the aforementioned property on date application is filed.
,rc�e�own</Shd�ya"'e) J1/L °'T`-,`m'"'�rnY 09
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Person autlro�ad Oy dNy ezewced
cy ic si.i-�z-0.�
permn lnum0er arM sbee; dry. sfa(e.
o� (rr�nrn, ear, ree�