HomeMy WebLinkAboutMortgage_Hayes (2)^' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_. + FOR DEDUCTION FROM ASSESSED VALUATION ✓
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�,.,� � Presai0ed M��M o( Lacai Govemmairt Finarce I. ; �
wsrRUCnoNS:
lt aL PsvJ ile
Fam filed with:
To 6e filed in person or by mail wifh the CountyAUditor w Counry Recorder o! fhe counry whele the p�operry is bcated., _ '� n
Filing Dates: 1) Real Property: Must file dunrg the year /or which the deducUon is soughG U I. I 1 F, f� A„a;�
2J Mobile / Manufauured Hanes not assessed as Real Pmperty Must file dunng the twefve (72) monNs � `"� Ty
befae MarcA 37 o(eacA year the deduUion is upaght U Counry Recorder
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See reverse side for addifional instrucUQns and 4valifications. /� ��" �_
^p�°"I� 6"y� -'�{ °"�a"'s°s�)„ _ /'� ,,� n GIBSON COUNTY AUDITOR I
�r.
If m. what b h'a! trer eracf share ot inteJesf9
tt nartre m remrd'o
..���-�l0 3(�-3�b�
Mort9aga / Cantraa intlebtetlness u�Pab as m
Marrh t, wrtent yrar
of � or mntratl sr�er (nuMer antl sveet �y, state, anf LP mde)
Name of assiry�ee or mhu owner or holdar M morcga9a
Aeares ol assiqnce (nfmi6er ene streei �: smte. arM
WoDertY
CR7
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� � e ofd num (/ � P� / V`� v
ll
/ Contract rtMebtetlrress �mP� as of Is Me sOP�^� the sole
Q kgal or ea�de oxTielt
O O � ❑ Yes ❑ No
wieotlmrtha sPa�.'uWuatewithwhom
Is the property in Questian: MnueOy AseiSeE
� Real RoPeKY ❑ %�!!��Y� . . _
If yes, what munt/? W�at Ta�d�y Di.^.4ict7 Mas N'a de0u�lion
tor a�rern yeaR
afpiopvly
❑ No
Di•a�ver i\�O ��/b ..:
.,.....
t� zo _ zo za _ zo
C a r d\` O. ..�°c, � l0. ......... ca,�N oa� c�m,. aar r�n
'� ia8, 9'�5 �j
1/ We certify under Ne penalry oi per�u�y ��a, ,.... __ . uiC furegoing infwmalion is We and mrtect arid that the appluant is a resident of IMiana aM
owner I wntracl buyer of Ne aforeme`rtioned property on date applicatlon is fiied.
irawr�e tawrie ruu nanml / o-aU (mmN. dar. YaeA
]dtlms W appfimnt (nWibe/ anC 54ea( tiry, Slate, antl LP cotla
°33 S • �oa W Owa-tSv; l
Rm M ewr e.edrzee aowr� a num�er or oy �c b�.�-�z-0.�
ACtlress of auCrorrzed prJSm (numOer aM sbae; �y, stare,
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