HomeMy WebLinkAboutMortgage_Anderson (3)'.> ""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
� FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fam 43709 (R8 / 2-07)
S � presmbed by DepaNnent of Local Go�emmenl Finaxe
HN
i e Mark
INSTRUCTIONS:
To be filed in person or by mad with the CourrtyAuditor o/ the county where the property is bcated. Q C T 1'] L(f U�
Fd'u'g Dates: i) Real Prope�ly: During fhe 12 months be/ore June il o/ the year the deduc6on is to be e/fectiva.
2) Mobde Hames assessed urMer IC 61.1-7: Behveen January 15 and March 2 0/ Me year fhe deduc6m is to be e9ective.
See reverse side /w additiorol insWctions and qualifications. ��.� �Q�
Dislticl
1�E_�
-see
GIBSON
Key rnan6er I Iegal descripGon Remrd nan�{ Page ^�^ �+
a(o-I�3--a`f-�a�oo0-3�-oaS � u �
rry as d March 1, anan y�r Mortga9e / ConVact ude6tedrreu unpaid as ot Mart�h t, Is Ne app5�nt Ihe sde legal w equitade o+me/7
aRen� v�ar S� � �'� ❑ Yes ❑ NO
share ot irMrest? If wmed wilh mmaone olher Uw� spouse. indicate wilh whom.
reme m record is ditterenl Uian Ihal
Nartre of
Address
Narrre
mntraG seller (number aM ffieeG dty. sfa(e. arM ZIP code)
o.v�r w holder ot marigage
(nurn6er aiM sGee1. dty. 9afe. and
Does aPplicard own prapertY in arry oiher
caunty in Indiane7
❑Yes ❑ No
appmved in Ne amount af:
� �"�Q
I/ We cer6fy urider ihe p&�alq
Indiana and owner of the afwf
66 s.as
by duy e�cearied Pa
what co�mtyt ' I What 7eidng
COUNTY AUOITOR
� .. ��
�� •
6��
•+
Address oi autMr¢ed persm (numbe� aM s4ee1. my. slale. aM Z1P mde)
20
Is Ihe propeAy in quesUOn:
0 Real Properly ❑ Modle Home pC G7.
Has (his deduclion been requested on popgty
for artent yeart
❑ Yes ❑ No
i
20
��e and corted and that fhe applicants was / were a resident of
�.
Date (mmlh, day, yea�
�„a,�w. �,:,�n