HomeMy WebLinkAboutMortgage_Flanigan.+-=�^n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township
T.. 1 FOR DEDUCTION FROM ASSESSED VALUATION M R 2 4 2009
SUte Fartn 43709 (R8 / 2U7)
���;: '� Presaibed by DeOartmenl of Local Govemmenl Finante
INSTRUCTIONS: a
To be �led in person orbymail with fhe CountyAuditor o/the county where the propertyis located. � G�BSON C�TY AUD
Fding Dates: 1J Real Property: Dudng the 72 months be%re June il o/the yearthe deduction is to be aAeclive.
2) Mobile Homes assessed under IC 6-1.1-7: 8efween January 15 and Maich 2 of the year fhe deduclion is to be effective.
See reverse side fw additanal instructions arrd qualifications.
qppl nt (owner or mnVa buyer - see resbVCGOns m reverse siCe) ./^ n J � .
G{QG�t� (,liv�o., V�.CJ�
Tabng Dislnd Key number / legal desaiplion Recottl number
alo -/l -ao-aoo -oo/. o a-v_v,��
Year
Pssessed e of real po as af Mart�h 1, curent year MMgage I Contract iMeWednws unpaid as of March 1, Is Ihe appfiont Ne sale legal a equitade ownen
curteM year
%OQOO ❑Yes ❑No
.. .n, what is his / her ezaq share of inlerest7 If wmed wiU� wmeone dher �han spouse, indicate wiih whom.
If rame on recwd is d'rfteren� �han Ihal of applicanl, indiole below: Is Ne property in quesUon:
� ❑ Real Property ❑ Mobile Home OC 61.
......,y,.y ......................,..... � — ^ � I
j �vl
of mortgagee a canirad seller (number aM streeC riry, stafe, end ZIP code)
Name of assignee a ather avrrer w holder of mwlgage
Address oi assignee (number eM streef. nry. sta
Does appliwnt own propeRy in arry other
courriy in Indiana?
❑Yes ❑ No
Deduction approved in lhe amwnt of:
20 0 20
SignaWre of Counry Autliwr
1 I We certi under lhe penalty of perj
Indiana a owner of tlie aforementioncv
at e owners lull nertre) �
i�� V� ��
Full residenl address of applicant (num6er end st
J�/SL S, GC/� STAT
Te�ti
20 I 20
zo
Di•a�vc►• \'O. �?�-..9 �s .
_
Cai•d NO . ..................... —
�KY
� No
i
zo
Uiat the above and fwegoing information is true and corred and that tlie applicants was I were a resident of
property on March 7, 20
Dala (ma�th� EaY Y�/)
�ily, state, aM ZlP aotle)
zoA,> �s P���<<��
or by IC 61.1-12-.07
Address of aulhoraed persm (number arid street dty. sfafe. eM LP coae)
Date (mmN. day, yea�