HomeMy WebLinkAboutMortgage_Buckler^^n STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED �trlt,p� � g�
:i-� : ' State Fortn d3709 (R71 / 6W ) 8-� � .� J
�' ,�„ � PreSaibeE by Departmenl of Lncal Govemment Fi�ance �
Coun Township Year
File Mark
�WSTRUCTIONS: DE�^ 2
To 6e filed in person w by mail wiN the CountyAUditor or Counry Recorder o7 the lnry wh�e„ fhe pioperry is located.
Frlirg Dates: 1J Real Pmperty: Must file dunng the year for which the dedur�fior�i�saugbG-
2J Mo6ile /Manufactuied Homes not assessed as Real Propehy'M e fhe fweNe (12) months
before Maich 37 0/ each year the deduclion is saight.
Seereverseside/yr�addiGonalinstruuionsandqualific�tions. GIBSONCOUNTYAUDITOR
If name M reoold
Key ber/kgaltlesaiption
i_ � (o-OVrdS- bn-O
�v�y � w �aae � ca, �ea� ��e as or
t. amen� / G[ ! _ 9/1
�ebw.
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Name ot mortqagee or om�^:_ -�.
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0
,J No
Deductian aGP�'v� ihe
20 _ � 20 � 20 I 20
I 1 We ceRify under fhe penalry of perjury�at the a6ove and
owner I contracl buyer of the afaemeMioned properry on da
im6eraMStreej �af�y,slate.2rMZIPCp
l l �Ah UG•
Powet a(Attomey or Oy IC 61.1-12-0.7
Address of author¢ed persw� (number arnd sLeet dry. state. an0
Fwm f�ed wiN:
��Counry Auditor
❑ Counry Recorder
Rem�d num
�o. S BS-C�dtl c
Mwt9age / Cmtrarl udebtedness �m7aid a d
ate of appGCation
someo�re
NT31 Tarirg Oistrid?
is fileA.
20
spouse,
Page
IYSi��iO
Is tl�e {voperty in question: Mnuaoy Atsessed
❑ Real ProPeKY ❑ ��Y �
Has N's de0uctian Deen requested m property
for arteru Y�r ❑ Yes ❑
20 � 20
is W e and correct and that ihe applirant is a resident of I�iana and
Date (mrnth. tlaY• Yee�
n�•� (monrh, d�Y Y'�