HomeMy WebLinkAboutMortgage_Asberry (9)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ � FOR DEDUCTION FROM ASSESSED VALUATI� �� �
�• State Form C3709 (R71 / 6-09)
S,.,. � PresttiCeC by DepartrtreM af Ldal Govemrtrenl Fnance
File Mark
INSTRUCTIONS:
To be filed in rson w b maii wifh the Coun Auditw or Coun Recortler o� Ne coun !1 FO1m fl� �:
Pe v b �Y ry th� pro�}}s rocated.
FNrg Dates: 1J Real Property Must fJe dunng fhe yearlor which fhe derluction is sought. �6ounty Auditur
2) Mobde /ManuFaUUred Homes not assessed as Real PropeRy Must file &Li� (12) months
6etae March 31 of each year the deduction is sou�ht ❑ County Recorder
Seareversesideloraddifion^linstructionsandqual�cations. GIBS� C._,.O_U�NT�v
�Ma��m(owneramnfr�buyer-}E�qreJhictioramrerel�slde)ii ��7 I/ / �U61{FAR
b is ' Key m�m6er / legal d tion emrd number Pape num
��- i a- 07 3b . I7-C�
seaed value d real qopeny as d Mortgage / Contract irWehted'ress unpaid az of Mwtgage / Contratl irdebtetlnrss unpaid as Is Ae eppfmant the �^�°
art�h t. mrent yw fdarch 7. artent year date af aPG�� �egal a eputtade oxnM
❑ Yes ❑ No
m, what Is his I hu euG share of infeJest? tt awnad with sameone other Ihan spouse. indimte wiTh wlwm
If name
Name af mwtgagee w convacl seller
wntrad se0er
martgage
neeress ot assiqnee (numce. a.a saeet mr, siere.
Is the PmPertY in auestion: MnueM Assessed
❑ Real Property ❑ Mmualy Assessed
Does aPdi�nt wm p�operty in any oNer I I( yns. wfiat munq/.� I NTa� Taring DrstnU? I Has �his deau�fion Eeen requested m Property
munry in Intliana? tor wrtent yeaY.+
❑ Yes ❑ No � ❑ Yrs n
n