HomeMy WebLinkAboutMortgage_Asberry (7)"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
± FOR DEDUCTION FROM ASSESSED VALUATI� � g g�
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• S�ate Form 43709 (R71 / 609) � F-�,
�' ,�,� ! PresaibeE by �epartrtreM of Local GovemrtreM Frarrz �� �
File Mark
INSTRUCTIONS: �UN Q t� �jj Fmnftedwiw:
To 6e filed in person or 6y mail with the CountyAud'Rw or Counry Recorder o/ the county where flie propLr� is located.
Frling Dates: 1) Real Property: Mus! file dunng the year fw which the deductnon is sougpc � �nty Auditor
2) Mo6de / Manu(actumd Homes rrot assessed as Real Property: Must fiieau t 12) months
before March 31 of each year the deduction is sought. Counry Recorder
Seereversesideforadditionalinstruclionsandqualificafions. G�BSONCOUNTYAUDITOR
Asesse0 rWUe d real PmPert�/ at d
Ma�di 1. tlarent year
� If ro. what is his I her exaa share ol
M
Name ot rtartgagee «(nnv&1 se0er
Address o( mat9a9� or mntraU se0a
Name af asvgnee or
� ��-/a-�6-�a3-Oo0_
Mor(gape / ContraU 4Mebtedness unpaid as of Mortgaqe / Conttz
Mamh 1. a�rent ynar // �__ dafe of appG�lior
appGCanf. u�dicate Cebw:
tity. 5lete.aMZIP
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DeEUC � /10.�_.G
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�nify u�Mer the penalry of perjury �fat the above [
/ contract buyer of the aforementioned Property on
w by IC 61.
of aW�of¢td person (numbermM sbcet nf�: state. enC
mmeane
I �number � / P�eo� O 7�
unpaitl as of Is Ne appl'xant Ne sole
legal or equllEble awfrefi
❑ Yes ❑ No
IS iM PlOpEfl`� VI QIlPSf1Of1: MIN12O)' AS555C�
❑ Real Roperty ❑ Mnually Assessed
I N/hal Ta�drg DiStriIX? I Has lhis d¢AUGlion be¢n requestetl an PtOplM1y
fw artent yeaR
❑ Yes ❑ No
)UNTYAUDROR
zo zo _ zo zo
Counry Date (rtmtb. daY. 3ea�
o� a �
ig infortnalion is We and correct antl Mat Me aDW��n[ is a resident of Intliana and
alion is filed.
Date (montli, day, yaa�
L
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