HomeMy WebLinkAboutMortgage_Drake'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE� n ship Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
S1ate Fartn 43709 (R71 / 6-09)
S,.�. PresQibed G/ OepertmeN ol Local Go'�emme�ri Fnar�ce
File Mark
iNSrnucnoNS: NOV 9 � F���,.
To be filed in person a by mail with Ure County Auditor or Counry RecoNer of the county wl�ere the property is located.
Fiting Dates: 7) Real Property: Must file durrrg Ne year (or which Me detlucLOn is soughL � Counry Auditor
2) Mobde / ManWadured Homes rat assessed as Real Prt�peAy Must file dunng Ne hvelve (1�s ,Q
6efae Maich 31 of each year the deducOOn is s�ughG r ❑ �^ry R��
See reverse side for additional insfructbns aM qualifications.
GIBSON COUNTY
roar��y{o�o.��n�,-��ayw�«���ux� ✓ A _ D
TaAng Distriu key num6er I kgal /esaiption Rxortl numEer Page rvmi0a
a�- � �-o9-aoo-ooy.osa-� aoio a
,� �� ��, �1�pa�,�,������,��� �,������� �,���,t�,�
MBiC11. ym Merth 1. a�Rnt yPar Cate of appGptim legal w equimhle a�el1
D O� ❑ Yes ❑ No
rc ro, wna� ¢ nis � ner emcc share or m+eresf? rc awrea wim sw,�ea,e otlm. man spause. uwKata ritl, whon,
If nartro an �emd a Qtlfe2nt than Nat of app6iant, triEirete Eelmr. is the WoG�Y rt� V�� Mm�aP/ASSessed
❑ Rea� Aoaenv ❑ aw,a�N o-�sed
abdie Hm�e nc stt-t
Nama m matpagee «m,vact xne.
a mnCaU
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(num6er antl snee; W}; slate, antl LP ootle)
ooe, �m o.m wov«ir �� a�y ouw I ir res,
cou'uy m �naena?
❑ Yes ❑ No
Drauclion aPP� m C�e art�ount of:
20 _ 20 _
Sy Une d Cauib AuEitor
rI I We cerrofy er Ne penalry o
owner / contra of Ne r
. � wre (mmef: M me) �
COUNTYAUOROR
20 _ 20 _ 20 _
Caunry
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that the above aruf foregoing infwmaGOn is we and mrtecl and that Ne appivant is a reside�rt of Indiana and
ned property on date appiicabon is filed.
Date (rtvah. deY. Yee� -
7�L5
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MCress ot a�Mo�sed Ge� (numberand sbeeG �'AY. state. entl
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