HomeMy WebLinkAboutMortgage_Martin (7)°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
s�e F«m aa�ae �as r 2v�t
S„� � Presaibed by Depanmenl W Local Govemment Finance
INSTRUCTIONS:
To be filed in person or bymad with the CourrtyAuAifor o7the courrty where the proper(y is located. FEB 1 � Z��9
Fd'aig Dafes: i) Real Property: Dunng the 12 montlis befae June il of the year fhe deduction is fo be e/fective.
2) Mabde Hames assessed Imder IC 61.1-7: Betxeen January 15 and March 2 of the year the deduction is to be e9ective.
See reverse side /or addifional ins6uctions a� qualifications. `"� _ /� d �
v • � a� n� i�-=t
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npp�1(wne.amnvadwryer-see 4ri�onsmreversesde) • GIBSON COUNTY AUDITOR
A� �ue of real qop5
G
If no, whal is ha / har exad
If name m recorE is d'Atera
�
Key munha / desaipibn Reoord num � Page rnanber -
- o- da - oo/. 9�9 - o�/ 00,5 sY(�
nch 1, anml ymt Mortgage / ConVaQ indebledness unpaiE as of March 7, Is Ihe appBpnl Ihe sde legal w etryiitaNe wmer
°'R�' �` FD a O
❑Yes ❑No
teiestl It owrred wiU� someone dher lhan spouse, indifate with whom.
�hat of applicarrt, inditate below:
Name of mmtgagea or cantracl seller
Addre55 of mortgagee or Gmtrad sGler (i
Nartre of assgrrea n dhel owner n hold
Atldress of assignee (�umiber arM sheet,
Dces epplica(ri avn propertY in arry dhu
caunry m Indiare7
❑Yes ❑ No
I Deduclion apD�'� � Ue amount of:
cify. sfate. and ZIP ootle)
� �����
LP cade)
20
Is Uie poparty in questirn:
❑ R�1 Properiy ❑ Mobile Home (IC 61.1
,�,,,a�ra Dra�ser i\'0..�� —
5........ �
• � No
_
Card 1\'O. .......5�/� —
woRO ••••••
��i�C�. 00 —
20 _ I 20 _ 20
Daln (rmnfh, daY.Yea�
I I We certify under Ihe penalty ot perjury that the above and foregoing infortnation is true and correcl and fhat ihe appGnnts was / were a residen[ of
l2diana and owner of the aforementimed property on March 1, 20 '
--e.-r—C •� t v, a a 1<
m,sdent address oF app��
%4� � lJ �'? S s �
an autlror¢etl by duly exewted Power
Pg�
streel dty. stafe, arid LP wde)
Wy, sYate, and LP coOe)
�� I Date (monN. daY.Y��
�7
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