HomeMy WebLinkAboutMortgage_Drury (3)� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C un T hi Year
_. FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm C3709 (R71 / 6-09) .
�' ,,,, � Presaibed M DePa��n of Local Govemment Fuarce -
MAR ��i�
wsraucnoNS:
To be fiied in person a by mail wiN the CounryAuditor or Counry Recoider o� Ne counry where the p�operty is located. F� �� ��
Fiifig Dates: 1i Real Property: Must fi!e durim,7 the }rear /or which fhe detluclion is sought. nry Audimr
2) Mo6de / ManuFadured Homes rwt assessed as Real PiopeAy: Must fiie dunrg the hveNe (12) months
before March 31 oleach yearthe deduclion rs swght GIBSON OU 1�1�1b�e�
See reverse side for addilional instnictions erW qualifications.
Applcam (owner moon{� 6uyer' see msnje9Qns m re�erse siie)
�i.��
M.
Oi Y1IPJPSl7
J� i (— L-l/i
r/ Contrac[ irdebtednrss unpaid as of Mort
a�rreirt W� � .. Oate
�wrie m remN a 6fteroit Wan Mat of app0�ant, Indirate DelaMc
ro
Name ot martga9ee «mntrsa se0c
aaaress a �ay� � �,aaa
Me�s at av9g�e (num6ar
Dces epplirent rnm popert
counry in Intliana?
De0uc5on epproved'v�'_
zo
aa d NAUGitw ,
�:
� I � V
�mpaitl as d Is ihe eppQ�t Ne sole
kgal a MW�e owlwYi
❑ Yes ❑ No
If wmed wiN wmeone dher Ihan spouse. iMimte wRh whom
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Df�atiser i\-0..q�(,b5. -.
Cat�� 1�'O. . I .. ., p
�ay... -
��h e� � 5� a�. � .. ;oF
� p,,,, �-
-� zo '� . C Y-�'`�Z5' �
Caunry
zo _
I/ We cer�ify undei e penalry of pe ' that the above arW foregoing infom�alion is true and correct arM
owner I contract ti r of ihe afae ' ed property on date appiiradon is filed.
. state. and ZIP
o SU� I SN
eY ic s�.�-iz-0.�
of authaaetl person (number aiM snce; dy. state,
Is Cie pioperty in Question: Mnueliy AsseiSed
�] Real PfoPe�Y ❑ ���Y �
Has Nis tleCwlim Ecen reQUested at pmperty
fw artent Y��! ❑ Yes
❑ No
20_ zo_
�c .�r.r�n
-a
at Me applicant is a resident o IrMiana and
Date (rtmtl�. daY. Yea�
o��e c�m. aar. re��