HomeMy WebLinkAboutMortgage_Bugher"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE ip Year
_,. FOR DEDUCTION FROM ASSESSED VALUATION
� � Smta Form 93709 (R71 / 6-09)
�,,,. P2saiba0 q' OePaN�M of Lo�l Govemrtrent Fnance
wsraucnoNS: OCT 0 5 ����*
Form file0 wuh:
To 6e filad in person a by mail with the Counry Auditor w County Recorder of tAe counry where the properry is bcated.
Fiti�g Dafes: i) Real Property: Must file durirg the yrear lor which Ne deduction is sought �� County Auditor
2� Mobde / Manufectured Homes rwt assessed as Real Property Mus! file dunng Me Avelve (12)�
befae March 37 0l eacA year fhe deducbon is sayht. `% � County Remder
SeeraversesideforeddiGonalinslnectiwisaMqualificatbns. GIBSON COUNT
MWm➢�(owrermm�traUb�r-see mreversesi]e)
� / IgQal desaiption
-�7-05 -'f�a -ba3.7/(o-a
Mortgag aCr�oniraa inOeMeEness unpaiE as of ��9 �9aPP���
i ! ✓. 0 � Q
ro. whal k Ns I hu e� share Ot interesi?
If nama m remN is dAleren� Nan ihat ol appOCant'uMira� beb�'
Name of rtrort8a9ee ar contraU seAer � �
Address d rtnr�agce «contraU seder (nuMer erd slreeL �Y. 5ate. aM LP codel
Name d assiryiee w otlm! wmer or halder af mortga9e
PdCrass o1 ati9� (number and atreeL �Y, sm�
eT s
ppey ePplimnt ovm pmperty in any oNc
munry m Intliara? ❑ Y2s ❑ N
oea�ao� app�o+� m me ama,�e oe
20 _ 20
SigreDUe U Camb AutlP,or .f . _ /
r 1
� J
f�
sE 5 -3 -�
n,�.,.,,a���m � -
couNTV nuor
2p_ 20_
Counry
sar�
iwrnbu
�� Im�����
1eg21 or eQWH618 ovmel!
❑ Yes ❑ No
spwse. udirate with hMm
re property in a�: /'��%�
Real P�peKr ❑ ilmuaOyPssessed
.3..50 f} C
O' O ::.....
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Dra��;er \O.. •
a9��..........
C�CCI 1\�. ........
.�' nb, oo�• ��
5 Date (rtanth, tlaY• Y��
�
I No
I I We cerofy untler�ie penatty of perju�at the above antl foregoing infortnation is we and correct and that the apptinnt is a residertt of Indiana and
owner / mntrad buyer of the aforeme ed property on date applicatlon is filed.
I ( /s hN reme) Date (morvh. daY. Y��1
11 ' ent aEtlrnss of appGrant (number antl sbee , sfa�, mM ZI j
O 5" �/ �5 S �Yw,✓ � .Z` 7 �
rson aWror�d Dy dWy enecured Power of AvomeY a M IC 61.1-12-0.7 � �(�. �Y. Y��
r
prlsm (numberand sbee4 �: .��. �d LP cotle)
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