HomeMy WebLinkAboutMortgage_McGathy"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTED�S� Cou nship Year
.r�., ; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fwm C3709 (R71 / 609)
�' ,,,. � Presaibed by Department ol Lod Govemrtrent Firance
�V 1 6 2009 File Mark
wsrRUCnoNS:
Fortn filed with:
To be filed in person or by mail with fhe CountyAUditw or Counry Recorder of the county whe2 the property�" lacated/�. �/
Filing Dates: 1) Real Pmperty: Musf file dunng Ihe year for which the deducfion is sought. Q�(¢� �v /.Ia-�� � unty Auditw
2J Mo6ile / Manufactured Homes rrof assessed as Real Pmperty: Must fi/e danng the tweHe (12) mbnths n
befoie March 37 oJeach ysarme deduction is sought. GIBSON COUNTY AU ITOW Counry Recorder
See reverse side for addtional inshuclions and aualifications. . _
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Mortqage/ Contraa inde6tedness unpaid as Mongage / Con�C intleMedn�x unpaid as d Is Ne app�ant Ne sole
Mard� i, artent r /1 Eate of appli�alion legal or eQUitade amM
� �%�! /� ❑ Yes ❑ No
If ra. whel is his / her euct Sha2 Of intere5l?
If nartre on �emd a diRermt Nan that of app&a�n, mdipte 6ebw.
rt�ortgagee or mntract
Name al assignee w oWu awner w hdtler d mortgage
AdCress ot assignee (number arM snee4 uN, �te, a� ZIP code)
Oces appfitant ovm popeM1y in any oNer If yes, wha
munry in Intlana? �,_ �_.
amountoE
is Ihe yopMy in puestion: MnuaOy Assessed
� Real Foperty ❑ Armually Assessed
0.bGle Home (IC 61.
mde)
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Wh
COUNTY Al'
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D�+�Y
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�rat�6f C�nry - or I Counry ��}'� I oate (moytQ.! Y Yy��
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i I We certify urMu Ne alty of perjury U a Ne above arM foregning infortnalion is We and correct and Nat Ne applicant is a resident of Indiana and
owner I mntraa buyer of the atoremerroone property on date appiication is filed.
�reture (owna4 hA n Date (month, daY. Yea�)
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Arevtle�atld�essolaPM��t(nu ra t.dry,state,arndZlPcWe� �� SV /I� /`v t�^�6.5
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rson auuwraed ey aNr exeartea vbv.er ar araner or cy � 61.1-1 z-0.7 oate (morrtl�, ear. r��
drgs of authortred persan (num6er aM sfreet. cily, stale, anC ZIP oode) . -� " . �