HomeMy WebLinkAboutMortgage_Barrett (3)^�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ a FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fortn 43709 (R17 / fiW)
�` ,�� f PrescribeE by DepaMrent ol lacal Govemrtrent Frenca
F
, sraucnoNS: F�q��
To be filed in person w by mai! witA the CountyAuditor or Counry Recorder of the oounry where [he pmperty is located. �/� f11�
R7'ug Dates: 1) Real P�operty Musf 61e during the yea�fir which the deduclion is soughL �� pddnt�iMlitlimr
2) MobBe / Manufactured Homes rrot assessed as Real Property Must file dunng the twelve (72) rtronfhs ��y��
befora Maich 31 of each year the deduUion is saght.
See reverse side Por aUtldional instructions and qualifications. �
Ao� oroontract6uYer-see onreverse/jde) i/
GIBSON COUNTY AUDITOR �
J
If �w, what
If `urtie m
Key num6er / le9al desaiN� Rem�d numbv Pa9e numDu
�-ri. _ /-.�/ -�oo _ ao . .��9- o-�-i � �� �6
as pt M1br�gage / Contraa indebtedness unpaid as of Mortgage I ConttaU uiOebteMass unpaiO as o� �s Ihe appfxant Ihe sole
Marc� 7, arten� yeer Oate of appfifat�on legal w �quita6le owneR
�IU Q(JO ❑Yes ❑No
r e�s share of interest? If wmed vriN mmeane aher Ihan spouse, ind'uate with whan
tlitte2nt ihan that of aCP��6 mtlirvte below. Is P�7enY in Question: AnnuaOy Avessetl
�Real Property Q MuivallyAssesSed " "'
Nartre o( rtartgagee or mntract seller /r �// /)
l%
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ALtl2ss of mortga9ee ar cmbact se�er (num6er ar�D'aseef,
Name of assi�ee or othrl owner w hdder of mMgage
ALE�ess ot as5ignee (num6er aM stree4 u�: state, aM ZIP
Dces aPWirvnt own property in any oNer If yc
counry in IM�ana? ❑ Yes ❑ No
approved'o� ttre amouni ot _ _ _ _
ciry. �5te. aM ZIP oode)
District? � Nas N's
far ar2
3�
sted on pmperty
Yes ❑ I
zo ao� 2, - 20_ zo zo_
o�-������� �o ...................
sigfawre a camb � 2 ., :w�uy oate (nwntn. dar. r��
C.1l�C� � �• • `-"� ��. •••.• .. Non is We and cortecl and that Ne applirant is a resident of I�iana and
1 I We certiry urWe "'
owner I conVac2 b� li- Q� 3�. 5 I �.
� Sig�uW 2(ovme/s /ul`l r yz I� �/ Date (month. daY. Yga�
w G•�' f-C/�/ O
F� rrsiEent adtlr�ss of appfirant (numberend sbee4 aN, s+ate, ard ZIP oode)
� (o�! $ � �4\1�e� � Je. O�ensu�
Pe1sm auNOirzed Oy CWy esecvted Pwrer W Attort�ey or by IC 61.7-12-0.7
Pddress of authorrzed perswi (numbererM svee( dry. slate, anC ZIP tode)
y
ear. rea�