HomeMy WebLinkAboutMortgage_Johnson^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS hip Year
:a=_.. �
FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fortn 43709 (R11 / 609)
�' ,,,, f Presaibed by Department of Wnl Govemmenl France
�NSraucnoNS: JUN 3 O 20�ie Mark
To be �led in F� fl� ��
person w by mail with the CountyAuditor or Counry Recorder of the aounty whem the property is locat .
Filing Dates: 7) Real Pmperty: Musf file dunng fhe year /or which the deductlon is soughL C.� Counry Auditor
2) Mo6de /ManuFadured Homes not assessed as Real Property Must file dunng tAe Rvefve (12) months
6ePole Mardr 31 0/ each year the deduction is sou�ht. unry Recorder
Seereverseside�oradditionalinstructionsandqualfications. GIBSONCOUN A T
eE rehie d rral P�+�Y as of
i, daatrt ye.er
�
If M. WIN� 6 NS I M1G fll2U SINfE Oi 1I1(CRSIZ
I( riame on remC
mortgagee or mntract seller
p�p' / Rewrd num0er P num6er
3- OG- o G Dll �% %
Contraq'udeCled�ss unpaid a Mortgage / ConYad uMebtednrss �sVaitl as d Is Me aVG�^t the sde
irtem year da@ Of appGWtion legal or 0quitade ameR
r7 /_ 7, '`i /) � Yes ❑ No
w contraG se�er (nurt�bv and stree; dry, stat, aM ZlP code)
r+ame m assgnee w amer wmer
AAdress of = ynea (num6er antl st2et ary. s(ate, entl LIY cotle)
Does appti�'an� own Woperty in any olher If yes. what munry?
caunryinlMiana? ❑ Y�
❑ No
Deduction approved in the amount of. �
20 20 _
sg�an,�.e a co�+n nwrt�
I/ We certify under the penalry of
owner� er o e a
Sign (o eh /u me
�
Wha� TavM
wmeona oNer lnan spouse,
property in puestion: Mnually AsesseA
ea� afoPeny ❑ n�,uanya�a
Abdle Hortie (IC 61.
p,-a�ti��r i��o.°? �.�/.-...... —
c:, �-� ��� . .. . . a. � g3 � �
• .........� .. ❑
���s/ %S� � —
�/
20 I ZO _ I 20 20 I 20 _
Counry Date (rtianth. dav. Y�d
that Ihe above and (oregoing intortnatlon is We and cortec[ arM Nat the applinnt is a resident of IrWiana and
ned property on date application is filed.
Date (monfi, day, ysa�
-d7i%—� /o� 30-Z��/
°5+���.�d� {�rn �e,-��(�
ezewted Power o( AltomeY � M�C 6t. t-12-0.7
Pddress of aNhor'¢eC persm (num6er antl street. tlry, sb(e,
; l ( P .�-�1 • `t7l�ds