HomeMy WebLinkAboutMortgage_Barrett (3).""� STATEMENT Of MORTGAGE OR CONTRACT INDEBTEDNESS C nship� ar
_ FOR DEDUCTION FROM ASSESSED VALUATION
Slata Form 43709 (R70 H i-08) �
� �,. � Pfawi6etlbyDepaM�entdLo�C,m�ernrteMFinarce
wsnrucnoNS: Jlk#� �a� 2009
To be filed in persm or by mad wi� fhe CauntyAuditor d the county where the property is located.
Filing Dates: i) Real Property: Must ke during the year for which fhe deduclion is sought. �/
2� Mo6de / Manu7actured Homes not assesse0 as Real Property: Musf file dunng tlie fweNe (12) months belare�a� f,��year
fhe deductlon is swght /f (�
Seereversesidefaadddionelins6ud"ansandqualfications GIBSON COUNTY AUDITOR
_ ✓ 2,._. �.9 . _w�/
r�xsessee v�ue ot �ea� c�ceM av w F�t�g a� C«n
Mamh 7. arteaN y9a Mardl 1, curr
�
N m. what is his I her exatl share d irmaresl?
tl fume an recntl is Cmerenl than lhat of apv�, vdimte bebr.
r� d�n�ee «cmuaa seo� 0�
Pddress d rtorigapea or crntatl seAer (mm6erand sLooL �: s1
Name d assigfree ar oiher awner w hdda d matpage
Pddrass d�ignee (ml�rtber aM s6ee1. `ip: s6�. and LP mdo)
Ooas aPP�t awn pfaperty in arry dher C yes. rha
caunry in IrWiaret � Yes ❑ No
Dedudion aVGroved'u� tlie amour� d:
Ei.'�'
Signature d Courty Audibr
I / we certify under
owner/mntract W
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Remd number Page number
a a�� I
unRaiA as d Is lhe appGfant Iha sda
legal w equdable ameR
❑ Yes ❑ No
I( amed with someone aher than spouse. iMicala wiN wMrn
� Na aovam � a��: amuraq Assessea
-�' Q Real Pmperty Q Mnually ASSesseO
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20 � 20 _
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oaa f�,o�en. aay, r�f
Ne abave anE foregaing eifortnation is We and cwred and that the applicant is a resitlent of Indiare and
property on tlate application is filed.
"�IF�A identadd s6(appficanl(mm6eradstreef,cdy, h>. ZlPmdo)
X �qs� s �sv uJ ��..��.,� �7G
1 Person aWhw¢e0 by duy axetuted Power of Attv`erey u by IC 6-1.1-12-0.7
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Date (monN, Cay, ycar)