HomeMy WebLinkAboutMortgage_Higginbotham (2)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Yea
; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Form 43709 (R71 / 609) t�
,' PrewibeO by OepMmeM oi lnml Govetm�ent Framx
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INSTRUCTIONS:
To 6e ned in permn w 6y mad with fhe CountyAud"ROr or Coun Recorder of Ne ooun whem the F� �� �
n a woaem � ro��ee.
Fitirg Dates: i) Real Property: Must fde during the }rear fir whirh the deduclion is sought N�V 1 Z� Counry Auditor
2J Mo6de /ManufaUUred Homes raf assessed as Real Pmperty Must h7e dunng the nveNe (72) mon s
be(ore March 31 o/each year the deduction is sought ❑ C�+^b Recordu
See reverse side for addifional instructions and qualifications. ��„
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GIBSON
�i - 3 =3oo-o�Y ��-17-D �/ o�-oio � �y2�
Mwt�age/ Conbaa IMe6te�ness unpaid as af Mortgage / Cmbact irMeMed�ss unpaN as of Is Me eppfcanf Ihe sde
March t, a�rtent r Eate o( appfrcation legal or equttade awnell
� ❑ Yes ❑ No
Ii owned with mmeane oCier than spouse. udi�te with whom
. OMItl'iE D2IOM: IS P�Y VI Q1125bOI1: Al11WdMASkSSGd
Real Property Q lvmuaily Assessed .._.
Name of rtartgagee or mntract seller �/�
A�dress of rtartqa9ee a wntract se�er (mmiber nd stroe; ray, state. aM LP mde)
Nama W assignre w othel ovmer or holder of mortgage
AdG`ess ot assignea (num6 raptl streg tlry, slale, antl LP tode)
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Dces epplitant v�m property in any ahej If yes, what �
muMy m InCie�u?
❑ Yes ❑ No
Deduclion epprwed'u� ihe amount at
20 _ 20 _ 2p _
�riamr0y i:amrywoimr //
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I I We certlfy un the penalt�
owner I contract buyer of ihe s
COUNTY
20
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. Ta�dn9 �6tri[
lll'11V�1' �'�...°?.0�0 —
Card NO. .y7, �iZ
20 _ I 20 _ I ZO
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the above and foregoing intortnation is we and mrtea ar�d Nat Ne applicant is a resident ot Indiana and
property on date application is filed.
Date (manM. daY. Y��
til}; s7a1B. enC
Pdtlress of authar¢ed puson (number aM sbee; cify, slale, entl ZIP code)
Date (rtnnlh. daY Y�
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