HomeMy WebLinkAboutMortgage_Gregory (3)^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ � FOR DEDUCTION FROM ASSESSED VALUATION
�• State Fortn C3709 (R71 / 609)
S i Preuribe0 M DeDartment of Loral Govemmenl Friance
�1STRUCTIONS:
To be filed in person or by mail with fhe CauntyAuditor or Counry RecoNer of the counry where the property is located.
Fiiinq Dates: i) Real Property: Must file durirg the year (or which the deductbn is sough[. ,I
2) Mo6ile /Manufactured Homes rrot assessed as Real Property: Must h7e dunng the twelve (72) months 'vl �
6efore March 37 0/ each year the deduction is sought.
C.
See 2verse side !or addifional instructbns and qualfications.
b s e m on reverse sida
MP� wnerwooritract uyer' e, str�chOniS . � .
GIB
�C�� -i9-i3_ aoo-oo
Asessed vdue d� property as o( Mwtgag / ContraG intlebtetlness unpaid as d Mor
M&di 1. aamV Ymr MaRl� 1 eartent year d3tE
M&d
11 m, what is his I her ezad shara of interest? If wmed wiM
It name on remtl'a N9erent than thal o( aPpGranL'cd'uate Debw:
Name of nartBa9ee «conUarl seDer �/
Address of rtart9a9ee a cantrad se0er (numb� end sveel, cn
Name of assignee or otlrer owner w twlder of morcga9e
Ad0 of assignee (numCer arN street rJty, sfate, end ZIP a
T . .�.J NF_ l3-
Oces apWifam ovm WoDertY in anY other 1( yes.
counry m IrMiana? ❑ Ye5 ❑ No
DraucGOn aOW� ui itre amount oE
� �
Si9nature gjCamNnuattw
C �
I/ We certify under ihe pen
1— ownerlcon buyero
/s � ( r )
�
F�ll 2sidem atldrcss ot appfimnl
�
Pelson au�lwi¢ed Cy duty execuf
Pddress of aWmr'ved person (m
File
2
SON COUNTY
Recortl nurt�hu
ss-oas � �
/ Contratl indehtedness unpaid a o( I:
urooae�
l. �o .9L
> 4Ma1 Tad(g Districl7
COUNTYAUOROR
zo � zo
za
�unry Audhor
Counry Recorder
�nt Ne sole
dta6le awneR
Yes ❑ No
Is Ihe W�NY m Cuestion: MnuaoY Assessed
❑ Real fhoGertY � ArnwaVY A�e�
— . _ _. . _MNv7r tirvne fIC G1.1:
GREGu� , ►�o�,�c.
/�+�'N.:.�-V
ia-��8�
..._,.w, rw�-•i
I��� M n Yes ❑ No
2i1 _ � zo _
Counry Date (monOr. OaY. Y��
of pe � that Ne abo M foregoing infortnaGOn is We and cortect arW that the applirant is a resideM of Indiana and
wementioned prope an date applicatlon is filed.
Dale (monfi, day, yea�
' ,(s�7ata,andZlPmtle) Q
- LS � � t/
rnxeto(AilomeY a bY IC G7.1-12-0.7 �� (��. �Y.Y��
rraM stree; dry. stale, an0 ZIP oode) .