HomeMy WebLinkAboutMortgage_Caudill"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 7ownship Year
__ s FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R71 / 6-09)
�,,,� ` Presaibed M OeG�M af Lacal Govemment Fumnce
File Mark
INSTRUCTIONS: ,J
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To 6e filed in person w by mail wifh the CountyAudifor or Counry Recorder of the county whe2 the property is bcated.
FiNrg Dates: 7) Real Property: Must file dunrn,7 fhe year for whicA fhe deduction is wught. Counry Aud"rtnr
2) Mo6Ae / Manufaduied Ffanes not essessed as Real Property: Must file during the tweHe (12J months �
6elore March 31 of each year the deduction rs sought. ' B�,�nunry Recorder
GIBSON �l
See reverse side fir ddi[� elinshuctbns ar�qvalifications. ^ � � ^ NTY qU01TOR
�°�DP�m(owneror -i?e _ �Menrseside) .�.
aneH
ro.
nane m
mortgagea or mntract sellu
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6difate bebvl
Mdress d rtnrc�a9s a mntraU seLer (mmDn a�C atreeG
Name of auignee w othe� owner
Aderass o1 assigtree (number end sUeeS �y, smte. an0 ZIP code)
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. . . . . .. at count}O
Dra�tier NO..a��.
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COU
c��-a.o. '�.59.7.....
�� ia� 50�. `� Zo
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Is Me appG�nt Cre sde
kgal p equitable owneR
❑ Yes ❑ No
tf owietl wiN somrane aher ihan spouse. iMi�te wflh Mwm
WMI Tarirg D'atria7
20
IS Me ProOe+�Y in Ouestiore Mmie%Assuv.d
❑ Real RoPenY ❑ ��!aM �
tlMUCtim Eeen rcGUettea m propeny
nt yeaC+ ❑ Yes ❑ No
2q _ 2(1 _
}y Counry Date (monfh. Ea � / _/'
I/ We ' u�er _ e penatry o rjury Mat Ne above a regoing intortnation is We and cortect arW that Ne applipnt is a resideM of Indiana antl
owner! mntract buyer of the errtioned property on appliption is fileE.
nwrArn law�ela/�nsrtnl� .. Date (monfi. daY. Y��
� DO W; n yaicl
a� � a�n ��� �
tity, SfetB. 3M LP oode)
/'1 . _ .
Address of auCmraed V� (numDel a�M sbee4 aN. state. and LP code)
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