HomeMy WebLinkAboutMortgage_Stevenson^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
� FOR DEDUCTION FROM ASSESSED VALUATION
� . . � Sfate Fwm 43709 (R77 / 649)
� Presrn'betl by Departrtierit o1 Lod Govemment Frence
� File Mark
� INSTRUCTIONS: c
To 6e filed in person a by mail with the CountyAUditor or Counry Recorder o� fhe county where the pmperty is located. JE fl �
FiNrg Dates: 1) Real Property: Musf file durirn� the year lor which the deduclion is sought. Counry Auditnr
2) Mo6de / ManuFactured Homes rrot assessed as Real Property Must fiie dunng Me twelve (12J monfhs C� �
6etora March 31 of each year Me deduction is sought ��nty Recorder
See reverse side lor addiWnal insWdawu arM qualificat'ans. GIBSON CO
��°,n-,t (owxi/� contrd buyer- see m.s1�'raw�.s m re�xrs�e siie�
Y / I in nGin ��Y- %%...,.. . . � "l /ni.om n...., �
nssessea rah,e d r� popercy as d
Ma�ch 1, aerart yPar
tl ro. v,ha� ts I�s I het exaU
Key numC[r I kgal tlescriptim — Remrtl Pa9e numb�
�ZG— —OGGi�O a �i
�rtpa9e/ Contra�t IntlebteCness unPaid as U Mwtgage / Contratl iMehtetlnnss unVaid as d Is Ne ePW�i 4re sde
Mam3� 1, a�r�R�r Eafe M appGCation tegal w equifade amel/
� l ' ❑ Yes ❑ No
ielest? tl wmed vrith mmeo� aher ihan spouse. hdinte wiM xlwrn
on �emtl s Mt¢rent N3n Vut of appYfan4 ��m�e �¢la
f rtnrtgagee «mntraU se0er r
, of mortgagce or contracl se0er (nvn6�end street �Y,
Name of assignee w other ovmer or hdCer ol rtprtgage
AdErcss ot assignee (numbar and stree4 �#1: s1s1e, end
Does epplimnt own pmperty in any olher
counrymind"afu? ❑ YEs
❑ No
Oetluqion approved in the amount o.
20 � 20
W Co�mry Auditor
arM LP mA
Is Ihe propnrry in Quesiion: MnuaOylvssesseE
� Rra� Hoaerty ❑ rv,nualy assessea
Drawer NO..���°�
Card NO. ....y 70-3.....
� — COUNTYAUUROR �
20 20 20
Counry
Queste0 on P�W�+�Y
� Yes ❑ No
20 _
Date (monN. daY. Y��
20
1 I We certfy u�er Ne penalTy of perjury that the above aM (oregoing infortnalion is We and cortect arW ihat ihe applirant is a resideni of Indiana and
owner I mn dqa buvprv( the aforementioned property on date application is filed.
IfId�IR�(OjyIIP�r; Date (monfh. eaY.Yge�
yj1�1(sinNjY–/ .
i9ent addreks of appfrcant (number antl sLeeL aty, s7ate, aM ZIP ootle)
G �� � s �so � �o�T B,e�N�N,,,,.�
aNM(aed Gy dWy ezewte0 Power of Attomey w by IC 61.1-72-0.7
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