HomeMy WebLinkAboutMortgage_Martin (42)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 70
:__ ; FOR DEDUCTION FROM ASSESSED VALUATION
State Fam C3709 (R71 / 6-09)
,,.,. 1 Presrnbed by Depanrt�en W Loml Go+emmcrrt Finance
File
INSTRUCTIONS:
orm N
To be filed in person of by mail wiN the CountyAuditw o� Coun y Rewrder ot the county where the properry is bcated.
Filirg Dates: 7) Real PropeRy: M�st file during the year fir which the deduction is sought. c �
2J Mo6de / ManufaUUred Homes rrot assessed as Real Property: Must file dunng the fwelve (12) months `� E �
befo�e March 37 0! each year the deduclion is sought.
See reverse side /or addifiona/ instructions and qualificafions. �'f/„� �
Year
County Recorder
� � �V %� GIBSON COUNTY AUDITOR
T� � Key numg—' `—"""'°" Remrt1 nu r Page mber
� &<°_-06-o7-s<oo-000. 03��7 i �97�
As�etsed vaM1m of real property a of Mortgage 1 Contraa inde6teEness unpaid as ot Mwigage I t:awe... __:Medness unpaiE as d Is Ihe appilmnl Ne sole
i 1, armnt year March 1, t O tlate of applicatim legal or epuitaNe wmeR
❑ Yes ❑ No
If ro. what's ha / her eYad share of interev? H awned wiN someone oNer than spouse. Gdi�te with whom
It name an 2mfd's dilFem111 Nan that ot aPP��L bOiCate Oebw 6 tlM poperty in O�estion: MnueP/ Assez,ed
❑ Real ProPenY ❑ ����Y�
„-.,,r.sv...�-
ot rtartgagee w contrad se0er (num6e� end svee4 �Ri: s+a�.
Name of assignee w othr! owner or twlder of matgape
AECre55 of a55'ryiee (nurtiber eM sfree4 �: �. en0
nt ovm pfoperty in any other ..I.R yes. wnel
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DI'1\YCI' ��...•:•••••••:......
zo Card NO. ....���.�1!.....
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W�at Ta�d`g Distrirl?
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f�25I�16 �UCf%11 �6C(1
for wrtenl yeaR
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ertify under e penalry ot perj ry Ihat Ne above and foregoing infortnalion is true and correct and Nat the appliran[ is a resident of Indiana aM
mntract b of Ne aforeme � ed DroCertY on date application is filed.
stafe, and LP oode)
� k.� L A/. �i
autlw�d by OWy �eaitetl Povmr d Avaney or Cy
Address of auUroraetl per�.,on (numbe� arM sheet �y. sbfe, antl LP rode)