HomeMy WebLinkAboutMortgage_Mayer"'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN � _ Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (RB / 207)
S � Presmbed M DepeM1me^t d Loml Govemmad Finarwe
�NSrnucnoNS:
MAY 1 5 2009 Fi�e Martc
To 6e filed in person or by mad with the CountyAuditor W the coulrty where the properly is focated.
Fding Dates: i) Real Property.' Dunng tlre 12 months belore Juire 11 0/ Ure year t7re deduc8on is to be e y�
2) Mobile Hortres assessed under IC 6-1.1 J: Beriwen January 15 and March 2 0l the year th '�AYkp e8ective.
Seeraversesidefwadditionalrns6uctionsandqualifications. GIBSON COUNTY UDITOR
icara(amer con b�ryer-s ies6i
�
T 'rg District Key nu
Assessed ralue of popary as ot Mardi i. �
If•.- �s his / het esacY share of inferest?
If ra� recwd is difterent Ihan Ihat of appl
Name of matgagea or mMraU seller
reverre
' ' o( ! XJ ' VU % . �fol � ^V 4J
Mwigaga / ConVaC indabtetlness unpaid as of March 1,
artent year / � / ^ �y>
_i v-
Address ot monga9ee «mnVaa saller (rnrn6er and streeG ah, s67e. aM :
Name of assignee a dhet ownar or hdder d mort9age
Address of assigrree (rMmi6e, a�M sheel, c'rly, sfafe, and LP oo0e)
Ooes applicaM own property in em� olher It yes. what cwMy?
courrty in Indara7
� � Yes ❑ No
Dedudion appmved in the amwrLL oE
20 � 20 _
Signature of Counry Audtnr
r.�
legal « equitable o.me!
❑Yes ❑No
someme olher�han apouse. in?cate with whom.
VJhat Taong oislnc
COUNTYAUDROR
20 20
�
Is Ihe property in quastlm:
❑ Real Pmpertv ❑ Mohle Hame pC 61.
s Utis dedudion been requested on praperty
arterrt yea(7
❑ Yes ❑ No
20 _ � 20 _
Y�A
I � I
IndWan end ovmer of tlieaforryementioned paropertY on March 1 20oing intortnation is tr. rn� f/� IVSC' /^� I�S � -'•...,t of
Y .Tv
,�,�e���,s,�,�,�� Cy� r�sr�- s —
�1,..�,.G�, �- rh.,,.�
address af applicaN (numb6f and sfreaf. aty. sFate. a� LP mde)
� lV Stafe Rd IG'fl Owznsu,t���
y¢ed yy duN erze�uled Paxm ot Atim�ey d by IC 61.1-12-.07
parson (numbeiandshcetdly,
O�r- I���