HomeMy WebLinkAboutMortgage_Kruse^'n STATEMENT OF MORTGAGE OR CONTRACT 1�E NE� oun Township Year
s FOR DEDUCTION FROM ASSESSED VALUATItNC ��
� . • State Form 43709 (R71 / G09) � .A �J
�' � Presaibed by Oepartrtrent of LaW Gavemment Fnance
�lSTRUCTIONS:
MAY � Z��Z FileMark
To be filed in F� ��
person w by mail with the CountyAudilor or Counry RecoNer of the counry.W� �fy is located.
Filing Dates: 1) Real Property: Must file durirrg fhe year for which fhe deduction is wugift: ��� County Audhor
2) Mo6Re /Manu/actured Homes not assessed as Real Pmperty: Must ne dunng the 2) months
6efaeMaich37ofeachyearthedeductionissought. GIBSONCOUNTYAUDITOR � �untyRecorder
See reverse side for addilional instructions arrd qu�l�catbns.
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R ht5 I h2f ¢%2C1 shN2 0( YIl¢f¢5t?
If rwm m recad'a 6Rerent than
N2me ol mortgagee or mnV'ffi se0er
/
Y1E�Y�d� GC�b�Y.
Address oT rtort9a9� or contratl srder (rumiber and sbeeL
>, s923 --O a."a oipfa� $�
AAOrigaqe I Contraa mtlebteMess �mpaid as W ls Ne appfmant the sde
date of ePP�� 1e9a1 w epuilable ownM
❑ yes ❑ No
tt ovme0 wiN someo�re other Nan spouse.
,� o I 2 -......
� D1•a���er NO•...:.......
�!+ vms� r��
6
I— g, q:.........
�M C�1rd,O� ,,•••• •• COUNTVAUDROR
20
Sig�aMe
I/ We certify under Ne penatly of pe�ury th� the above and fc
owner I contracl buyer of the aforementioned property on date
de�addresso(app4 t(numDerantlstieef,
�.
autlro�rzed W dW esecuted Pong of Attprt�e
by IC &1.
Pddress of aW�vaed person (numberaM sbee4 ciy. slate,
ZlPmtle)
20 _ � 20
Caunry
�5 MC pfOpLfly YI QUC540f1: iV1Al12PJ A�u65Ed
� Real P(operty ❑ AMUally Fv^sessed
Has �his tleGUdmn Deen
ro� a,�m yean
29
Date (��. daY. Y��1
� ProP�Y
❑ No
20
infortnaUon is we and cortect arM that the appiirant is a 2sident of Indiana arW
ion is filed.
Dale (nmfi, day. yea�
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