HomeMy WebLinkAboutMortgage_Talamantes"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_ FOR DEDUCTION FROM ASSESSED VALUATION
S�tn Form 43709 (R17 / 6-09)
,.,� PresmbeE Ey Departrt�e'ri a11o�1 Garemmerk Finarcn
e rk
iNSrnucnoNS:
Form t�e0 w4tl�:
To be filed in person or by mail with the Counry Auditor or Couny Recnrder of the wunry where the pmperty is located. /'1
Fifirg Dates: 7) Real Pmperty: Must fite durirg the year /or whicA the detlu�tion is soughL �l ���ty aWi{bi
2) Mo6de / Manufactured Nomes rqt assessed as Real Property: Must fiie durirg the fwelve (12) months ❑
6efore March 37 o/each yenr Ne ded�cL'on is �ht �^tY R�w
See reverse side lor additional instruct'ons arM quelifications. , �-
Assessed vah�e d� paprJ:y az d
Mamh 1, al�Mrt year
rc ro. what e nis / ner e�a snara or inwest?
H name m remtl b CtReren� tlun that of appOmni, hMirate Eebw
Name of rtnrt0a9� ar mntracl sWer /�'
Li
MdfPSS O} � R mflC'M'I SUIlf (/111IMPf BlIfI5VB8G � ID
Name of assiryiee or ather awner ar hdder of frotgage
PilC2ss o7 assiFce (nurtNer en0 snret mY. ��. an0 LP code)
Does e�pfitanl own DAPMY in any oNV I If Yes.
��cy �� �m�a
❑ Yes ❑ No
20 _
IIWec
ownerl
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GIBSON CBUNTV A1J91TOR
a� a a-�i� R ani� P���
r� unpaid as of Mortgege / Contraa'vMe6teE�ress unpaitl av d Is t�e spp�csnt ihe sde
tlate of appOption legel or epuitade owre(1
� ❑ Yes ❑ No
If owned wiM samearre oNx tlan sppue. trdimte wlih whom
property in Queston: MnuaDy
�I RopertY ❑ A!?vally �
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0
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c����� �ro. ..... ��09 ,—
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COUNTV
20_ � 20_ � 2l1_ � p_ � p
Dam (rtmN. EaY,
penalry M perjury Ne above and foregoing mformaGOn is true end wrraA aM that the appiipnt is a residertt of Irdiana ard
of Ne aforeme ed property on date aPq�atlon is filed.
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ewy �,�a aowx w nvcmer or cr c bi.�-i2-0.�
nearass at awumea cersm (numaeraie rneet �r, state.
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