HomeMy WebLinkAboutMortgage_Simpson (4)^^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
,___.. s FOR DEDUCTION FROM ASSESSED VALUATION
Stata Form 43709 (R71 / 6-09)
�' ,�,� Presaibed by OepartmeM o( Loral Govemment Fnance
e
��srnucnoNS: F� fl� �
� To be �led in person or by mail with the CountyAuditor or County Recorder o( fhe county wheie Ihe property is located. v q017
Fi/mg Da[es: 1) Real Pmperty: Must file dunm� fhe year for which the deduction is sought. �i I� C6MAy Audimr
2J Mo6Be / ManuFactured Homes not assessed as Real Pmperty Musf file dunng the fwelve (12) months
before March 37 0/ each year fhe deduction is sought. �� n Remrder
See reverse side fa additional insfructions and qual�icatiars.
nppkam(ownerormntrarlbuyer�seerestiic�6resmreverseside) GIBSON COUNTY AUDITOR
�
7 ' g�istria Keymimber/IegaWescription
� �' -1 -
AA¢sed vahre d 2al VnP�Y a d �C9a9e / Contrari i
A13rU 1. amN yeer Mart�h 7, wrtent yeei
rc no, what's his / her e�aa share ot interest7
It name on 2cad is dMemnt than that ot appGpnt irMinte Cebvr
Name of morttjagee or mnvaU seller
J
Mdress of martqagce or wnhacl snAer (number an � ef, ctiy, sta[e, �
Name of assignee w other owner or hddi
Address of assignce (rwmber ard stree4
Dces aPW�t own poperty in any othu
munry in IMiana? ❑ Yes
I
Deduclion approved In �he amoum of:
sbte, ara t�r caae)
If yes. what munp?
I No
20 � ZO � 2q � 20
�.�
If awned witti
nuortoR
Caunry
I I we certiy u�er the penalry of perjury that the above and foregoing intwmatlon is true a
owner I contrad buyer of ihe afommentioned property on date appliqtion is filed.
Person aWrori�d Cy
person (numberarW sbeeL �N, sbte, an0
RecoN number Page nyrt1Mi
- a�S oi To
Contra�i'umtlebtetlnnss imCaid as M Is Ne ePP��t Ne sok
OtaUOn legal or epultaDle axTreY.�
aQ � ❑ Yes ❑ No
x WMl ihan soouse. iMicffie with whom
Is ihe property in Question: Mnually Assessed
�"Rea� Ropertv ❑ ArmuaM Assessed
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