HomeMy WebLinkAboutMortgage_Richardson� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ = FOR DEDUCTION FROM ASSESSED VAL�#Adl�� ��
� State Fortn 437091R11 / 6-09) � � �
�' � PrewibeA Dy DeparlmeM of Laal GovemmeM Finance
File Mark
�To 6e filed in person or by mail wilA Ne County Auditw or Counry Recorder o/ Ne'dbLhty�erchH� �roperty is located.
Fifing Dates: 1) Real Propelty: Musf file durrrg Ne year for which the deduclion � so hf.
2) Mobi7e / Manufactured Homes rat asseued as Real Pmperty: klus��a(welve (12) months
before March 37 0( each year the deducfion is saght r-�
Seereverseside(oraddifanalinsWCGOnsarWqualijLcations. GIBSONCOUNTYAUDITOR
see
wrtem
If ro, what's his / her e�ct share o( interest?
If name on recnd is drtfemnt Nan that o( aOpGCant, uMirate Eebw.
Nartre ot mortgagee ar mntratl
�9a9� a
a'her owner or haldu d mM9a9e
Address of assi�ee (numbe� s�-�^�"••..
Ooes apptia a�' � ,
munryinlM �0,. • '-'
pi:l\\��'l , � � .
� � �15'��..
Dr�u�bon aPp !',ll � \O' .• • • �
l. ��la�' �
20 �'
5� 3 �c�i� ,
SigreWre W Cav.q wOrtw
-taD S� �6-G�/
unpaid as of Mortgage /
I O� date af a7P
tt ow�E wiM wmroi
i stare. aM ZIP code)
'. What Tari�g Disiricl7
� UNTY AUDROR
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Counly
Form Aed vn
Counry Auditor
❑ County Recorder
Recortiv` D I I Pa9e '75 '
�mpaid as of Is Ihe apd�t Ne sale
�gal w equitade ovrtp!?
n Yes ❑ No
Is C�e W�GP+�Y in Vurstion: MnuaM Asessetl
❑ Real ProPenY ❑ ��Y�
Mohle Hane OC 6
Has N5 dedutlion Oeen repuested m O�Y
for wnent Y�� r-� __ r� .
20 � 20
�yY��
I I We certify uMer the penalty of perjury tliat Me above and (oregoing infomialion is We and cortect and that Ne applirant is a resident of IMiara aM
owner I mntract buyer of the aforemen� date applicaUOn is filed.
resident aCCrw«
stat , anA Z1P ootle)
I �b. 4W�:.NSJ��+�� � ►1�4b
Person auUroraed bY 4�Y esecuted Pv«er W AtmrneY a bY IC 67.1-12-0.7 I oa�e (monN. dar r�
Pddressofaudmraedperson(numberarndsfiee4�ly.sb(e,arMLPmde) .