HomeMy WebLinkAboutMortgage_Maikranz (2)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fwm 43709 (R71 / 6-09)
S � PresaiDed by Departrtierit ot Lod GovemmeM Fuw�ce
File
wsrRUCnoNS:
To 6e filed in erson a b mail witA the Coun Auditw o� Coun Recwder o/ fhe coun where the m �� ��
P Y b' N N G pe+ry is located. nAm
Filing Dates: 7) Real Property: Must file dunrg the }rear lor which the deducLOn is soughG � C u Z ocrJ�ry q���
2) Mobde / Manufactumd Homes rrot assessed as Real Property Must ne dunng the fweNe (12) months
6eto2 Malch 31 of each year the deduction is srought ❑ Counly Recorder
See reverse side 7or additional instructions nd qualifications. o•.. �ff
InppG�nt(ownerwconvaabuyer-see reverseside) GIBSON COUNTY AUDIT
�
�I T' District Key / lega e pmn Remrd number� Page mimber
0��`�7-f�i'-&ao -?�?X-1. �o -oa/
rdhie real as d Mortgage/ Conb3�j vide6tedness unpaid az of Mortgage / Con�aaU inCebieCnass unpaiC as of Is ihe appilrant Me sole
I Ma�rh 1. Mart�h 7. arteni yWy(^� O� date of appli1atim� legal O YPS ❑ ND
��7
Itt m, what's his / her ezaa share ol interesi'! If ovmetl witl� sw�one oihar than spouse, iMimte with whom
III narne m rem�tl's Eifferent ihan Nat M appOrant, U�ditate belaw. Is tM operry in Qurstion: M�waOy Asw_ssed
� eal PmPertY ❑ ArmualyAssessed
MoWle Fiane QC fr7.1-i
IName ol morigagee a mntraU seller ��% �j% _ /� ^
�7\ iC� �IIJ��Vn�/n�J
IAddress of rtiartgagee ar mntraa snder (num6er aM sbee4 �+1Y. ffi�, aM LP )
� Name at assignea w oNU ovmer or hol0er of mortgage �
Mtlress of assignee (numDer aM spee4 �y. sfele, anC LP cade)
Ooes epplicant oxn pmperty in any oNer If yes. Mat muni)!+ What Taring Distrid? Has �ha deEur�m Eeen requested m Proprny
countyinlnd'ena? _i_I_."___f_l..w. ____ twartentyeaY.+ � Yes ❑ No
DI.'�1i'CI� 1�TO.�P.�.,(.—...... 7UNTYAUDROR
IX
Ca1�C� �i�. .....T„�.� �... 20 20_ 20_ 2(1_
g Counry Date (month. daY. Y��
{
I/ We cer4fy ndu �he nalty of perju at the above and foregoing in(ortnaUon is We and cortecl arW that the applirant is a resident o( IrMiana and
owner I contracl buyer of the atoreme� ed property on date applicatlon is filed.
Si8 (ownerS /iAname) Date (monfi. daY. Y��
IFull ` ent address of appl' t num0er an0 sLee4 �; �. and ZIP aotle)
'15 or a- `l �
Pason autM�aN Oy 0�ly execu;ed Prnwer o(AUCmeY rn Cy IC 61.1-12-0.7 Date (rtronN. EaY Y��)
Mtlress of a W�w'ved person (number aM stree; dy, state, and ZIP wtle) .