HomeMy WebLinkAboutMortgage_Hubbard"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm 43709 (R71 / 6-09)
,,µ � PresaibeE by DePaN�rV af Lo�l GovemmeM Futerce
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INSTRUCTIONS: F� �� �:
To be filed in person w by mail with the Counry Auditor or Counry Recorder of Ne county where fhe pioperty is located- � 7 (�'
FrNrg Dates: 1) Real Property: Musf file durirrg Ne year fof which the deduction is soughL S� �CoHn� 7LS�mr
2) Mobde / Manufadu2d Homes irot assessed as Real Pmperty Must h7e dunng the nveHe (12J months � �nTy Recordu
before Maich 37 0( each year Ne deduction is sought.
See reversa side for adtlilional inshuctiw�s and qualfications.
1 np prmno-auayyu-see r�eisesee) , ' n,/ / /'� GIBSON COUNTY AUDITOR
1 rahm d mal RoP�Y az ot � Mortga9e / Gontrart v
qn¢M yrar Martl� t. airtrnc yrar
Nartre of rtangagee «mntrsU se�kr
Addresa ot nn�ja9ee ar mntraG sW
Nama of azsignee or othu awner w Y
R¢co rwmDr,r Pa
mpaiC az of Is Me aPd
v� u No
teresn I rc mmee wim someone ot� u+a� sp6use. ma�ate w,m wnom
o( a0P�4 mdkate bebw: Is tt�e P�P�' in 0uestion: MnuaM Assessed
❑ Real RoPertY � %�!?�!�Y �
dimM ovm property in any oNer
Ind'ena7 ❑ Yes ❑
Deauma� app�M.-0 4f tlfe amouM oE
20 20
�re� � ���
� I I We certify under Ne penally of p
amer / contraa buyer M the atore�
� (owneYxlu9reme
aM Z/P cade)
.n � � —
COUNTYAUDROR
20 20
�m
the above anA foregoing infmnation
Property on date aPPliption is filed.
� ull racident adCmss of appi'�n (numbe� antl 4 mY, �ta, and ZIP mtle)
�iJ / z /e
aersori a�uroracd M aWr e•ewred ao«er or nmmer a M �c rri.inz�0.�
AOdress af authomed person (number and sbee; city, state. enG LP code)
DbtricY/
hlas Nis
far wne
m
No
Dra�ti�er NO.??'o.�:D........
Card \O. �.�.�..�......
3fld
� /y�/umi. wry• 1'eerJ
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Date (monvi, tlaY Y'��