HomeMy WebLinkAboutMortgage_Huelsman"'r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
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� FOR DEDUCTION FROM ASSESSED VALUATION
• Sta1e Fortn d3709 (R71 / 609)
�' Presmbed Ey Departrte(rt of La:al Govemrtrent Fnance
w.
INS7RUCTlONS:
b 6e filed in person w by mail wdh the CountyAuditor or Counry Recorder o/ fhe counry wAem the pmperty is focated.
Fifirg Dates: 1 J Real Pmperty Must tJe dunrg fhe year for which the deduction is sought. JI
2) Mobde / Manufactured Homes rwt assessed as Real Property Must file dunng the (welve (12) months
before March 31 of each year the deduclion is mught.
C
See reverse side for addiUOnal inshuctions and qualifications.
N--1.Q �`--' O - b �/�7 - UU-
0.ssessed vehie d real paperty az of Abrtnape / Conbaa 4debte7ness
Marti� t, aarem ymr Marrh i, airtem year
I
I( ro. wha� a lus I her exaC share Of Nferestt
�f retre on remE s NRerent Nan UHt oi appf�ant, ub�c2[¢ Df
Nartre Of mort4a9ee or mntrari seller /�
�l.lil
Address of mort9agee w mntract seller (nwMer and
Name of assignee or other wmer or htltler M mortgage
MOress oi asvgnce (number arid stree4 �: slate, aM Z/P c
Ooes aDPlicant axn praperty in any olher If yes
munry in Indiana?
❑ Yes ❑ No
DeducGOn appmveE u� ihe artwunt of:
20 20 20
Sfete. aM ZIP tode)
7c0' u/�d
35 W Mortga9e I ConGact
date o( appfi�tnn �
H o�v�red
� t_
DstrK1?
GIBSON COUNTY
��ry Auditnr
Counry Recorder
un7� az d h Ne ePP�� tlre sde
legal or equitade ovrt�e(.�
❑ Yes ❑ No
tiicate w�th Mtnm
�e WoPenY in Oue^�OOn: Mnua�y A55e5se0
Real HoPehY ❑ M^�a�Y Psscssed
Has Nis tle7udion Eeen re9uesteE m PtopenY
tor turteM yea(.�
.i . � ' ❑ Yes ❑ No
N�Zsm�, S-�,��1 e
� /.� a,e,a A
2(1 � 20
�ruWre ot Counb litor I /� — SQ:.� Sti Date (monfh. deY Y��
Cl
I I We certify under Ne penalty of perjury Mat ihe above aM foregoing informatlon is true and cortect arw mut the applinnt is a resident of IrWiana aM
owner / conVad buyer of ihe afae nlioned property on date appfiration is fileE. '
rem� - Date (monfi, day, yae�
sbfe,
Dy duty executeA
person (numbe�aM sbeet dty. sbte, anC ZIP code)
� y7�
o�e (mann, aar. r�n