HomeMy WebLinkAboutMortgage_Halbig^' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ FOR DEDUCTION FROM ASSESSED VALUATION �
� Stata Fmn C3709/R77 / 8-09)
�,,,, � PrewibeE M�M of Lttal Ccromment Fu�ance
INSTRUCTIONS: F� fl�
b be filed in person or by mail with fhe CountyAUdifor or Counry Recorder of the counly where Ihe poperry is located. c �� Q
Fifig Dates: 1J Real Property: Must file dumg the year Ru whicA the deduclion is soug�G `� P� Courrty quditor
2) Mo6de / Manufadured Hanes rat assesscd as Real Przy�erty Must file dunng fhe tweNe (72) monNs � �unry Recorder
befae Maich 37 of each year the deducbon is saght.
See 2verse side for dilional instnicLions aM qualificafions. ��� �
nppr�cani(owreror buyer-aeara�smre �) � GIBSON COUNTY AUDITOR
a
7a " Oistrict, Key rnxnGer I al desaiP� Remrd rt1Der Page �wm6r+
'i l� 3
A�ssed vahre o( rpal proper,y as d , M ye/ Contraa udebteCness unpai0 az N Morigage / ConSari ude6tedness unpaid as of Is the epp6tant Ihe sda
Marfh 1, w�mt Y� Me 1 rteM Y� date of aGP���^ legal or M���de ovrtceR
❑ Yes ❑ No
H ro. whal La h's / her eme share of Inlmrst7 N v+ne0 wiN someorre oUtar Ihan sVwisa. NdKate wilh whom
dt
Nama M rt�ortgagee or mntrarl seller
Address of rtart9agee w contrace se�er (numbar
Name o1 avgnee w other owner w hdder ot mc
d'zam own G�PeM1Y in anY oNer
InOiana?
❑ Yes
oea�aon aav�e � u,e amount ne
20 _ 20 _
sigranne d co�cib a�anor
�1 I We certify u�er Ne penally of,p
owner I mgtraarp�;y�r of th��r
trMitate beMb�r.
s1etB, Bntl7�? mtlel
I
I No
�
IS i1M WuPenY N CUCSIYY[ Mnua9Y A45es5eO
❑ Real ProPeKY ❑ ��Y �
Mobile Hortie (IC 61.
Nis dedumm bern reGUesteE on propvty
Dra�r'@I' ���...�Ol D ❑ Yes ❑ Ni
. . . . . . .. urtent YPaR
caCd,io.....3�99
..............
° l � !� SQ� •� p— �—
Caunry Date (rtqnlh, daY. Y��
and foregoing infortnaUon is true aM cwrecl and that Ne applirant is a resident of IrWiana ard
i��te aPWxatron �s filed.
o-a� (mo�m. dar, rsen
�ti eEdrels of appfxant (numDer and s8uet dry. s+ate.
a�r S l �� �..� �
mr�d d�Ay esecuted Po«er U y rn by IC Gi.
auttror'¢ed persa+ (number aM stree4 �'. ��. an0 2
Oate (mMlh, d3Y. Y��