HomeMy WebLinkAboutMortgage_Altgilbers"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 7 ship Year
__ .� FOR DEDUCTION FROM ASSESSED VALUATION
• State Fam C3709 (R71 / 6-09)
� y,� � Presaibed by Departrtrent af LocW Govemmenl Fnance
File Mark
wsrRUCnoNS: FEB 1
b be filed in person or by mail with the CounryAUditor or Coun RecoNe� o/ the counry where the �"� �
N v�ae�N a �ocared.
FfTing Dates: 1) Real Property: Must file durirg the year for which the deduction is sought C.�. Counry Auditor
2) Mo6de / Manufadured Homes not assessed as Real Properly Must h7e dunng the tweHe (12J monfhs
6e/ore March 31 o/each year Ne Ceduction is saght. Counry Recorder
See reverse sid�7or addifional instruclions and qualifications. GIBSON COUN
MPrram ( Quyer: sea � "�'?e s�Ve)� _ _ �
KeY num0et I kgal �srnptirn� Remtd �c Pa9e
a(� �d-/ "7- I al-G�F a3S od�l �V �`(�8a
� rahie of 2al popaty as W Abrtpage / Contraa indebtednesa unpaid as of Mortgage I Con�aC "udebtednass �spaitl a of is Me app6rant tlu sok
1,qrtaGyear Memhl,curremyear eata�fappGmwn� legal ❑Yes ❑ oN
t T
�n m, what is his / her emct stwe oi inteJest?
tl rwre m rem�tl'a E'.Rurn[ Nan Ihat a1 app6mm, u�Einte bebw.
Name of rtnrtgagee a mntraC seller
Address ot rtqrtgag� ar mntreG seAer (mmber end straeR �1: sbte. er
Name at assignee or oNer owner rn halder d rtqrtgage
AOdress M assi9nce (numbere� sbee; ary, sfete, aM LP code� �
Dces applicaN ovm pw�•': _
munry m IM�-' �
�n��.
D`�`\,`,` `O..• �(J-
3'� . .
�`"d ���, ��3 ��v
F�
1 I We certify under Ne penal
owner I contract huyer of Ne
;nanire fii0ireme) n
by dWy
' NTat Ta�dng D'svict?
COIINTY AUDROR
za � _
spoum.
k IM P�D�Y in question: Mru+eM Acusud
❑ Real ProPenY ❑ ����Y �
Has Nis deTiCion been re9uestetl m P�PP+�Y
ta wrtnn ynar.
❑ Yes ❑ No
� � �
m�s-�--�_ I_...., �c�a� � V..W,..__.�.=� i— I f
Nat Ihe above a oregoing infortnation is W e and cortect arM Nat the applinnt is a resident ot IrMiana aM
ned property on date application is filed.
�ate (/nanDi, deY.Y��)
Power o(Attome�lor W IC 61.1-12-0.7
P4dmsv of aulhor'¢� person (numDer aM sbee; Ury, slale. antl ZIP mtle)
Date (monN. daY. Y��
'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_. ; FOR DEDUCTION FROM ASSESSED VALUATION
� � . State Form 43709 (R77 / 6-09)
��" Presoihed by Departmenl af Local Govemnrent Frence
NSTRUCTIONS:
To be filed in person or by mail wiN the CountyAuditor or Counry Recorder of the counry where (he pmperty is located.
Fiiirg Dates: 1J Real Property: Must file during the year fo� which Ihe deducUon is sought. D E
2) Mobi/e / Manufectured Homes rrot assessed as Real Property Must file dunng the fweNe (72) months
6etae March 31 of each year Ihe deducfion is sought.
C.
See reverse side /or additional instrucfions arM qualifications.
>��a' �nlnwinrn..nn�ralln. .n<r.;fr:...e.,...e..e...e..ne�
� Z�ntyAUditor
n_ CounN Remrder
- GIBSON cUUrv � , •,�••� ".•.
Ta�dpg �is�triri Key number / legal desmiption Ref �d numDer Pa e numbu
7 7, -/ - O l-�t a d� - O '/ 3- D O/iZ SoL/
As¢s� vaqc d real paperty es d Martqa ge / Cantracc irdehted�ress unpaid as W Mortqage I Contaz3 irdehtedness �mpaid as d Is ihe eppBtanl ihe sde
Ma�h 1. nvmnt Y� Mamh 7, airte�rt year dete of aPP��� I�al n equitaGe ameR
9� ❑ Yes ❑ No
If ro, wfiat Cs his I her erart share ot interest? If wmed wiM someone oNer Ihan spouse. udkate wflh whom
If �urtie m �emtl is dMUent than Nat of aPPlicanL 4Mitate EeWvr. �61Mi�°perty m Question: Mnua�y Ass¢ssed
^�}x�ROPeRY Q?mn!aMAss�sed _ . _
Name of mortgagee or mntrar� seller
Address ot rtartgagee w contracl srAer (number n�
Name W assignee w other owner or hdder of nqr�gaga
�
DeducCan approved in tlre amouni ot
20 I 20 I 20
�
I I We certify under the penalty of
owner I wntracl buyer of the afon
the
whatmunt�7 � tTap� Dc
COUN7Y AUDROR
20 2�
�ir
1\D...Y �/�.....
.........
Dra�ver �
' .......
NO. . � � ...
Card ... . ....
5�, 9���
t 20 20
nd toregoing infortnation is we and cortea antl Nat the applicant is a resident of Indiana arM
date appliratlon is filed.
Euly ezewteC Power oflCtl6may or by IC G7.1-12-0.7 I Date (rtronN. tlay, yea�
V
I person (numberand sbee; dry, slate, ard LPmde) ,
r,