HomeMy WebLinkAboutMortgage_Flaningam"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS To ns ip Year
_. FOR DEDUCTION FROM ASSESSED VALUATION
Sia[e Fwm 93709 (R71 / 6-09)
,' ,,,� ! Preuribetl q' DePe�nt o( Lafal GovemmeN Financa �
wsrRUCnoNS:
MAY �'IeM���U
To be filed in person w by mail with the CounryAuditor or Counry Recorder of the counry where the property is located. F� ���
Fifmg Dates: 1) Real Property: Musl file dunng Ihe year (or which the deduction is sought. ���y q�d�p�
2) Mobi/e / ManNacturad Homes rat assessed as Real Prt�perty Must file dunng the hveHe (12J months
before March 31 of each yaar the deduction is saghf.
GIBSON Y AUDIFO�ef
See reverse side /or addilionaf inshuclions and qualifitafi0n5. �
I AnoHaant (owner ormnlraUb�mr. see resLiraons on re`eise sdeli i _ _ l
3 Distr'xY Key numhu / desaipton / Remrtl numbs Page numbu
fi.�.f.c. a- o s- a. o- aoo - 000. � v�-oi� i o c;
sed va4ie ct real Vo�;Y as d Mwtpag e/ ContraG irdehtedness unPaid as d MMgage / Con7aa iMebteMess imGaitl as d Is Ihe ePP�t the sde
i 1. nrrelrt year Mart3i 1. artent Y� tlate W aPGGcatn^ Mgal n equiHNe mme/i
OO ❑ Yes ❑ No
Wh2I l5 h15 / 112f OYdQ Sh2I9 O} V11ClBSl? i O'MIBd With SOrt1EOI18 OIhBf N3I15pOLLSC. Qd1�IB NSIh NTprtl
�e m remN's dRerent Nan Nat d aPP��. ��� �� Is C�e perty in Questim: Mnualty Assessed
Reel PfOpCrty � AMU31hJ AssE55Cd
0.bble Fiome C 61.1-i
: M rtqrtgagee or mntrarl seller , �
ss of �mtgagee w mntract se�er (num6er end street u�l: �e. end LP cade)
Name N assignee or other awner or hdder of m�age
PdEfass ot astignce (number arM aheet ury, stefe.
Ooes epplim`rt own propeny in any oNer
munryinlntlanal r-� "
a��� oe
code)
�
Drawer NO...... ��......... —
W�atia '- .b
I No
.��430 —
COUNTYAUDRO C�l'(� �O.'..••••••••.•••••••. —
� . �:�Io15,C'1..10•°Oi
20 _ 20 _ 20 _ 20 _ 20
�renrte of Co�m Auditor � Caunry
I I We certify under the pen of perjury that Ne abov an0 (oregoing intwmation is We and correfl anC t�at Me
owner! contract buyer of aforementioned property on date appliratlon is fileA.
by duty
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G-v`
�ak� Z'�� �766
orCyIC61. -12-0.7
persan (number aiM sbeeL ml: stefe.
� �
Date (nanfh. dav Y��)
�,Pplicant �s a resident of IrMiana and
Data (rtwifh. daY. Y��
Date �rtpnt�. day 1��)