HomeMy WebLinkAboutMortgage_Roudebush^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun .. Towns ' Year
, FOR DEDUCTION FROM ASSESSED VALUATION
Slata F«m 43709 (R71 / 6-09) - �
� / presajp�y py pepa�lmeN of Loml Govemme�rt Rrenro
"" File Mark
wsrRUCnoNS: OCT F .
To 6e filed in person w by mail witA the County Audhof or Counry RecoNer of Ne county where the property is located.
FiNng Dates: 7) Real Property: Must file dunrg the yearlor which the deductlon is sought County Auditor
2) Mobde / Manulaclured Homes not assessed as Real Property: Must file durng Me tweNe (72) nanM� ��nry Recordu
6efae Maich 37 0( each year the deduction is sayht O'�
See reverse side loraddirionel inshuctions arM qualilcatons. GIBSON CO
Ap�e�m(°x�erar9orP'aubyu-3Cereslri�°^s9"/e.e+sesee) _ n � /
r I legaf desaipdm
/o-:�G_�ao -UO�
Abrtgage / ContraG irde6tedness unPaia as of
Marti� 7, airten[ year
shara of interast?
It narne on remd'6 6Rerenf Nan Nal d app9pn4
Name af mortgagee ar conaaa
„�•;�.�.3•'
w other owner or holEer d mortgage
N assignee (numbarend streeL �: smta.
Does ePplzant own D�v�Y in anv omer
muNy m I�ana? I-'I .,_ _
of
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ctiy, sfate. aM
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b[etlness un0aitl a d Lv Me aPP�� tlro sda
legal w eQUka6k owneR
� p�017 ❑ Yes ❑ No
sPn+se. rtmd�te wrth whom
,I�sp/� property in VuesGm: MwaAy 0.scaeE
ld R2al RuPeAY ❑ Armually 0.s�sed
7� AbWle Fiortie (IC 61.7-i
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1/ We certlfy under Ne penatty of perjury Nat ihe above and foregoing intortnation is We and cortecl and Uiat the applicant is a resident of Indiana aM
� owner I mntraa Mryer of the afdemenboned property an dale appircatlon is iiled.
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