HomeMy WebLinkAboutMortgage_Steele"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__, + FOR DEDUCTION FROM ASSESSED VALUATION
� Sta[e Fwm 93709 (R71 / G09)
,�.r � Presaibe0 by Departmerit af Loml GwemmeN Frence
Fil rk
INSTRUCTlONS:
To be filed in person or by mail with the CountyAuditor or Counry Rernrder ol the county where the property is located. �
Filhg Dates: 7) Real Pioperty Must file dun� the year for which the deduction is soughf. nty Auditnr
2J Mob�7e /ManuFactured Homes rrot assessed as Real Property.� Must file dunng the tweNe (12) months � C 0 2
befo/e March 31 of each year Ne deduction is snught. �ty Recorder
See reverse side lw addNional insVUCUons and qualifications. '�� �p � ..
IAPP��t m 6 -sea rererse . e) ' [j
GIBSON COUNfiY � i7aA
7' trict ' Key nmber I al descriD� ' a_/��' ��� —�� Recofd num6er Pa e rt�qerO
(1 ��
7 ' 7"
AssesseE rahm of �eal poperty az of Mortg�ge / Contract indeCtedness unpaid as of Mortgage / Cantract inEebteEness unpaid as d Is Ne a0d�� �e sole
Mart3� 1. aa�art year Martli 1, artent yrar date of appGt�a' legal ar equitade owneR
Yes ❑ No
Itl ro, what is his I her e� share of intemst? If o.me0 with mmeone dhar Ihan spou.u, indkate wah whan
�1 narne m remrd'a Eifte�ent than that of aOP�^t uMicate Eeb�r. Is IM P�D�Y in Vuestion: MnuaPJ Assessetl
❑ r� a�oPenv ❑ /vuu,aiN a�
Modle Hame pC 61.1-7
I Name of mortgagee or mntract seqer � n n .
Address of moriqaqee ar wnbact seller (numba� and sbeel, rlry, state. aM LP code) —
Name al assgnee w or mortgage — I
,
.a•�Q�•......
AdCress ot assiryiee (numbar end seee4 �Y. smte. entl LP code) D r���� Cl � �
Ooes aPdi�ant own yoperty in any oNer I( yns. what wunt}? What Tadrg Distl �••`! O�•• ••'''
munry in InCana? ' , O • •
� ' ❑ Yes ❑ No C�1 d 1�
COUNTYAUDROR � �J`�'11�v �
Oe�u�tim appmved in 4re artount oE
20 20 20 20 _ 20 _ 20 20 _
Sigfawre W Counry Auditor Counry Date (monM. daY Y��
I I We certify under �he penalty of perjury Nat Ihe above and (oregoing infortnalion is We and cortect afM that Ne applicant is a resident of IrMiana arW
owner / conVact buyer ot the aforementioned propeRy on date applicatlon is filed.
� Sigiaw�e (owneYS hA me) Date (monfh, daY, yea�
. F appGmnt (num and stree4 �: e, ard ZIP )
auNaaed Gy duy ezewce0 Power of AttomeY a M IC 61.1-12-0.7 Daic (matlh. Oal: Yea�
Pdtlress of author'¢etl persan (number a�M SbEet, ciry. sta(e. antl ZIP mde) .
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