HomeMy WebLinkAboutMortgage_Robinson (7)..°''� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_. FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Farm 43709 (R10 /17-08)
��.0 � PresuibeE DY �Mien� d Lo�l Gwernmeiri Firence
MSTRUCTIONS:
To be filee in person or by mad wr� fhe CouNyAWitor d the county whera the property is located.
w;�y oa�as: �� a�� �,o�: M� raa a� u,a y�. �, wn;�n rne aee� u�o„gnc MAY 1� 2009
2) MobDe / MamAeGUreO Homes not assessed as Real Property: Must file durrng tl�e hveNe (12) months be ae Maich 1 0/ eadi year
the detluction is sought
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Nare d assignee or o0�er ox'rer or Mder d mMgape
Pddress af assipnee (rwmbw aM stree; rd�: s6fi. and LP mtle)_
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❑ Yes ❑ Na
Deduclion aCProved in Na amouM d:
20
Sgnatura d CouMy AWitar
20 � 20 _
GIBSON COUNTY AUDITOR
Recard numbar Papa number
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Yes ❑ No
H wmed with someofre olher Uun spousa. ind'rale wiTh wlam
Is me pioperty in Queslion: AnnuaN' Assassed
,� Real Properry Q Mnuaity 0.55esseC
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20 _ 20 20 _
LJ Yes LJ No
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I/ We certify uMer the penaity of perjury Ciat the above and fwegdng u�fortnation is We aiM cwred and that the applicant is a resCent ot Indiana aM
owner I mntrad buyer of Uie aforementio�eA property on da[e appticatlon is filed.
5 jnatura (wme/s fiA name) Date (mmHi daY. Y�A
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FW rasidenl adEress d appGCanl (mmNermNStree; rdy, ffi�, aid LPcode)
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rass d aWMrized persan (numDer andsGeet, oTy, s6te. an0 LP mdo)