HomeMy WebLinkAboutMortgage_Kares"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_, ; FOR DEDUCTION FROM ASSESSED VALUATION
Stata Fortn 93709 (R71 / 6-09)
� Pr¢wibetl by Departrnent ot Loral Govemmenl Firence
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iNSrRUCnoNS:
To be �led in person or 6y mail with the CountyAuditw or Counry Reoorder of fhe county where the property is located.
Filirg Dates: 1 J Real Pmperty: Musf file dunig Ihe year /or which the deduction is soughl.
2) Mo6de /Manufacfured Homes rwt assessed as Real PrtipeRy Muu file dunng Ne IweAre (72J months
6efore March 31 o/each year fhe deduclion is srought.
{ �} �Omppty Audimr
�j CU11
LJ �nty Recorder
See reverse side fw additional inshuUions and qualifications. C'�
�'°� nl� rorcontrdC6u�ye/r-7seer.e�st' °"� 2ve ' e) �
l / / An .i n � . �[/ !1L . . A A i , / /i Dn /1 GIBSON COUNTY
�a.�sm�a����
�MarU 1 ament year
IIf ro. what Is ha / her exaa share ot inierest?
If name on remrd'a EMerent Nan Nat o1 aoo!
— -0/ - U-{iYJU./� -U d V//
/ Contraa'udehtedness unpaid az W Mortgage / Contraa rtiCe6ttdness unPaid a d Is Ihe ePP�t Me
Ma i, artent ynar tlate of appGUtion /1ij !Wq legal p tqullable wmeY)
�/ cl�i ❑ Yes ❑ No
If owncd witA someorie oNU Ihan spouse. iMicate wuh wMm
on; i�Winte bebw p�peny in Question: MnuaOy Assessed
�Real Property Q Armually hsses5ed . . .
Name W rtqfig�jee u mntraG se0er �/
\
Mdress of rturtga9ee or contraU sWer (numbu and se
Name W assignee or rnher awner or hdder ot rrortgage
AdCress of assignea (num0er arM street �'. s+ate, and
Dces applicant ovm property in eny aNer
munty in IMiana7
❑ Yes ❑ No
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COUNTYAUDROR __ __
Deducuon aCP�� m tlre amount of: -� ,.� T((
KA �-S � �Zr 'y`
Zo �_ � K� .�
sy�n�a or rA�,ry a,a��o�
I I We certify under the penatry of perjury Mat the above arW fon � v I I_ I���
owner I contract buyer ot the aforementioned property on date a
��Sig a (ownershAlrm�na)( _ -
e� Ftill resqEnt eCdress d�pfrcant (rndnberantl street, tlfy, sbte, and ZI
,� � � ►�c �c�n � � �
Pason authward Ey dWy executetl Pawv1 W Attamey m by IC 61.1-12-0.7
Pdtlress af auCiavEd person (number a� sbee; ciry. sfa(e. arM Z/Pmde)
� P�Y
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�m, dar. rea�
I is a resident of IrMiana arM
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