HomeMy WebLinkAboutMortgage_Nelson^`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_ • FOR DEDUCTION FROM ASSESSED VALUATION
� State Pofm 43709 (R71 / fi09)
� f Preunbed by DeparhneM of Local Govemrtrent F�ance
File Mark
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To 6e filed in person w by maii wifh the CountyAuditw or Counry Recorder o( the county where the property is locat
Fifing Dates: 7) Real Property: Must file dunng fhe yearlo� which the deductlon is sought. Counry Auditor
2J Mobile / Manulac[u2d Homes iro1 assessed as Real Property Must fi/e dunng the (weNe (12) monfh� .�.
befo2 Malch 37 ot each year the deduction is sought. unry Recorder
See /everse side Ipradditional instrucLvns and qualfiyations. GIBSON COUNTY AUDITOR
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Asmssed raM1ie of real qoperty as W
Mamh 1, au�art year
If ra, what's ha I her exarl share ot ii
tt name m mcurd's diRerent Nan iha
Name of mortgagee or contrad seller
Aildress of rnonga9ee w wntraU se�
Name of assignee or oNer owner or Y
+�agai aescx�p � rcecam nu ra e nun ur�
-o _ 03 -OO°. di9 D��- I �-{ -
ortgage / Contract irMe6teCness unpaid az of Mortgage / ContraC inde6tedness unpaid as of Is Ne app&ant Me sole
ard� 7, arterrt ynar tlare of appGcation � legal or eQUhade owneR
O � . ❑ Yes ❑ No
tt awned wiM someone other Ihan spouse. indkate with whom
Minte bebw. Is rty in question: MnuaDy Asu,ssed
eal ProPerlY Q Mnualh�Pssessed
MoWle Home QC 61.1-i
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i street, cily, state. aM ZIP code)
mortgage
tlry. slafe, aM ZlP code)
limnt ovm poperty in any other I 1f yes, what muny.+
Intliana?
❑ Yes ❑ No
DeducGOn approved m the amount
20 � 20
Sigreture d Counry Autlimr
20 � 20
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1 I We ce,rtfy under Ne penalry ot perjury ihat the above and foregoing infwmalion is tn:
owneylmntrad buyer of the aforementioned property on date application is filed.
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person (num6erarM sheet, cR}; slate, anC
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