HomeMy WebLinkAboutMortgage_Hinkel"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun�
.�_..
. FOR DEDUCTION FROM ASSESSED VALUATION
� Sta[e Fwm 43709 (R71 / fi-09)
�' w f Presaibetl by DeP��nt of Local Govemmem Ffance
INSTRUCTIONS:
To be filed in person w by mail with the CountyAutlitor o� Counry Recorder o! the counry where the properry is located.
Fif'mg Dates: 7) Real Property: Must fde during the year for which the deduction is sought.
2J Mo6de / Manufactured Homes rwt assessed as Real Property Must fiie dun� Ne twelve (12) monfhs
be7ore March 37 ot each year the deductnon is sayht.
See reverse side fw addifional instructrons and qualificafions.
Fwm
AppGc�t(�merwcmtraubuyer-seere�ot�wnsor�anerse�n ' / _ � GIBSON
ed �rehre d mal p(openy a d
ahre
1. ctrtel4 yw
IXI
6er/ aldewip'—
M�tpage I Cantracl'v
MArth 1. arreirt year
Name of mongagea a contrad seuer /.7�
G �
Pddress d mortgagee m m�trad se�er (number
Name d assi�ee w othu owner or halder o( �rotgage
Pddress ot assignee (numDer anC snee; rny, state,
Does applimnt own properry in any oNer
apryrned'o� Ihe amoum ot
20 I N1
I I We cerUfy u�er ihe penatty
owner I contraG buyer of thepl
�y, sbm, aM LP code)
I aare ot aPpufauon
��C
tt awned with someone oG�er Ihan
yes. what munty.� � What Tabng Disl
4o��ud"rtor
Caunry Recorder
AUDITOR
ness unpatl as a� Is Ine epp�nt me sae
� legal w eWitaWe axnM
❑ Yes ❑ No
ise. i�rtate witli htpm
M DIpOPrtY Yl VIXSLOfI: MftlIdOY ASSCSSM
Real Pfoperb ❑ �M�
p���„��,�.o.. aoo� .....
..�a�!�....
CardN�• p...
� 1\LJI�� �a LI No
2p _ 20 _ 20 _ 20 _ 20 _
Counry Date (monN, tlay, yoa�
Ihe above and foregoing infortnalion is We and correcl and Nat ihe applinnt is a resident of IrWiana antl
property on date appfiration is filed.
_7������ ,�/� O � ��� `�� ° �
FW revtlent address W aP t(rwmber antl sbece4 �: stale. and Z/P ootle) �'T rJ � 5'-1 Ln �/�� /'7 (� L�/�i
L � � � �L
Person authoiaeE Ey duy executed Power o(Aitmiey rn by IC 61.1-12-0.7 Date (rrronN, daY. Y��
Mtl25s of auCroraed person (number aM sbeel. ary, sbte. and LP code) .