HomeMy WebLinkAboutMortgage_Teeters (2)'"n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tawnship Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
Smte Fortn 93709 (R71 / 6-09)
�' y„ Prrsrnted ty Departnwn� of tn�-vl Goremme'rt Fu�erice
File Mark
wsrRUCnorrs:
m
To be filed in person or by maii with the CounlyAuditor or Counry Recorder o( the counry where the pioperty is located.
Filing Dates: 1) Real Property Must fife durmg Me }rear /or which Ne deducfion is sought. � Counry Auditnr
2) Mobde / Manufadured Homes rat assessed as Real Property: Must file dunng the tweHe (12) months '--)�� �
6efore Ma�ch 31 o(each year the dedudion is sought. // 13�
See reverse side 7or additmnal instruclions arid quel'dications. G IBSON COUNT Y AUDI
I AvvL4��� (o»„er or ronrrde auyer- see rastriraa�s m reve+se s:fe) A . ,
J Oistrict �/ KeY number I legal desaiPtion
� v .�
-p -oo-
Asessed vahre d mP�b as d A1ortpa 9e / Contraa N
A/amh 1, a�V Merd� 7. �7yesr
/ �
K ro, what Is his / her exaG share of interest?
tl nartre on recoN a d�ifuent Man that of appOCant uMifate hebw
Name of mortgagee «mnVarl selkr
ly
Address of nargagee a contraq se�ler (number e snoeL cily, sbte, 6
Name of atsignee a oNer ownet m
AGtlmss
rtqr�qage
stete, aM LP mtle)
Recqy num0er Page wmbu
7� - 000. � 83-0/ 7 r}-o 0 3(� �
iness unpaid az of Mongage I ConraC iMebtetlness unpal0 as d Is Me appNrsnt tlre sWe
Eata ot aDP� � °f �'�� °NT�
O ❑ Yes ❑ No
tt ovmed v�iM sameorre oCrer Ihan sCa+�. iridka[e wmh whom
property in any other I If yes, wha[ muntyl I What
❑ Yes ❑ No
Dr�umon a7P�� u� Cre amourLL af:
,,��
i ��� �� ��
� '
i/ We certify er thi
owner I mntrad buyei
Sig o lYfiArenu
X- /�,,,,,,,,1 /,
PersOn
�_
Is tt�e praperty in puestim: MnuaDy hssesSeG
�4%al ProPertY ❑ Mnually Asse�ed
0.bb'le Fdorne (IC 61.
Has Nis tleA�m Deen reGUested m poperty
���' n .,__ n
�_
COUNTYAUDROR Dr'��f'C'1' (�'O �
...�Ol�
zo zo Card i1'O. .... �,�o�o�..
��h 8�,a��.�,
Nat the above arM toregoing infortnaGOn is true and cortect ard fhal the applirant �s n.._
ned PropertY on date aPdication is filed.
. Date (morrN. daY• Y��
�n; �ata,
pr�sm (numberaid snee4 �: slate, e�0
(�en, aar. r�
d