HomeMy WebLinkAboutMortgage_Kiesel (15)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTED Coun Tovmship Yeat y
__ FOR DEDUCTION FROM ASSESSED VALUA�'IO���
State Fartn 43709 (R11 / 6-09) ��
,' ,,,. P Presaibetl by Department of Lncal Govemment Fnance .
oa.. ��...�
wsrRUCnoNS: MAY �. Z���
7o be filed in person w 6y mail with the CountyAUditw or Counry Recorder o! the counry where the rty is located.
Fd'mg Dafes: i) Real Property: Must file durirn� the year (or which the deduclion is sou�qt.�J,
2) Mo6ile /Manufactured Hanes not assessed as Real Property: Must fiie during fhe 2) months
6efore Ma�ch 31 of each year the deduclion is sought.
See reverse side Ioraddi " nal instrucfions andquali�cations. GIBSON COUNTY AUDITO\
MP��t (mmeror - see rewicwps p� rc.ers� sfde) � �
ti�w��-iL �y_
Tav�gD1A//1,�A/,G . �number(7�b�—�l1—�J—�VV—W�. ���-[.l�J
As5e55eE vahie � � p�opsty
�Mafdi 1. ticm1V y�r
M. N{Nl {5 hl5l hM EYdC Sh3f0 Of Vli¢RSl?
It name m mmN is tlitferent Nan �hat W aPplirant. uW'vate Gelow.
xt�ee «crnuaa
mort�agee w �untrt
Name of assignee w otl�u owner ar halEer of morigage
r::r�
state,
Mtlress of assignce (number arM stree4 dy. slate, and Z/P tode)
F�, mea wnh:
�.ounty Auditor
� ❑ County Recorder
indebtedness unpaid as of
Page
Is ihe propeRy in QuesUOn: MmiaOy As:xsse0
❑ R� �oaenv ❑ av,��y ws�a
No
Does appikant own ryoperty in any oNer I I( yes. what county7 I NTaI Tari�g DisVict� I Has Na detlufl'mn Ecen `equwted m propcty I
counry in InOiana? ❑ Y2S ❑ No for wrtenl yeaR ❑ Ye5
❑ No