HomeMy WebLinkAboutMortgage_Davis (4)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ , FOR DEDUCTION FROM ASSESSED VALUATION
Sfa[e Form 43709 (R71 / 6-09)
�,.�. � Presaibed Ey DePaN�M o( Lool Govemmanl Fnarrce
INSTRUCTIONS:
To be filed in person w by mail wifh the CounryAudiror or Counry RecoNer o/ the county where the property is located.
Fi/ing Dafes: i) Real Property: Must file dunrg the year for which fhe deductlon is wughL E P
2i Mo6de / ManuFactuied Homes rwf assessed as Real Pruperty Must file during the fweNe (72) mon s
befole March 37 ot each year the deduction is sayht.
See reve�/or atlditional instmcGOqcqnd qualifiwtions. �%%
aypfiram
Key numCer / lega desaiptim
�G- � �-la. - lo�-�../
1 vaNe d real qoperty as d Mortgape I Con]qqp22a intlebtetlnrss unpaid az of I
arren�year MarCht.wr�n/QOO
��� /
at is ha / her e�ad share ot inteJestt If owned r
��o,��a�,��u� �y�
Address of nwrtgagee u contract seller (number and street, ciry, smte. a '
Name af assignee w othrl owner or halder M mortgage
PLCress at assignee (number aM saee; ciry, slete. antl LP mde)
Does aPdimnt wm property in any oNer If y¢v. whal wunpR
coukymintliana? ❑ Ye5 ❑ No
Deduvan ap{vvo�.ed'ui Uie a�^--• _"-- .
20
I/Wec
owner /
NTat Tadig
Drawer NO...°���.........
Z �s i ......
,��� Card NO. ..... .....�•
� �nl,ar,o• /
���. e, p.N.g• : . .�
�t bu r c ,, ,�_ ,....e.c cytnicaoon �s nleA.
/�1 �/l�cr�..; 7/ //G� �,u, �„// c
w,wa�d oy awr e=�,�ea ao�r ur r« M�c u,.,-iz-0.�
W autlratreE pnlson (numbe`a� sbeet �1y, stdte, aM LP code)
0
Counry Recorder
GIBSON COUNTY AUDITOR
tgage / ConVaQ uWebteEness urlpziC as Of Is ttie eppOVnt tlfe sde
r of ap(1Gwtion �egal or equitable owne/?
❑ Yes ❑ No
swneorre athrl ihan sPa+�.'udicate wiTh whom
k Ifre G�PeRY in Vuesiion: Mnua%AssesuG
❑ Real RoPerty ❑ Annual�Y Pssessed . . _
Has Na tle0wyion Deen requestea m pmperty
tm curten� yean. ❑ Yes ❑ No
2� 20 2� _
o�� c _d.CU'�
md correct and Nat the applicant is a resident of IMiana a
Date (rtmfi, daY. Y��
C
�