HomeMy WebLinkAboutMortgage_Beadles (2)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
• Slata Fam C3709 (R71 / 609)
� ` PrewibeE by Departrtrent o1 Loral GwemmeM Frenca
� File Mark
INSTRUCTIONS: ���
b be filed in person w by mail with Ihe CountyAuditw a Counry Recader o/ fhe county where the property is bcated� N F .
Fi/ing Dates: 1) Real Property: Mus[ hfe during the year (or which Ne deUUClion is soughL Counry Auditor
2J Mobde / Manufadured Homes rrot assessed as Real Pmperty: Must file dunrg the twelve (72J month
betore March 37 0/ each year the deduction is saght �6 Counry Remrder
Seereversesideforado'itionalinsvuctionsendqualfica6ons. pIBSON COUNTY AUDITOR
����� rYYI � byrer see nn �/!. �eise sida� /� A7�Y
�
OisOiC
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a�e .an�e a rea� v�cenr � w
Ma�d� 1. armnt year M
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n �. �� � � i � �e sna�e a ��gr+
tl name m �econC 6 E'ifturnt Nan Nat of app�-ant, InOu
rw�m of rtarrgagee «m�vaa seuH
ACd2a d rtnrtgagee a contraG srder (numbe� a s0
Name a/ ystignee cr Whel owner w holder d fmtgage
nneres or assignee (nurMe. end street �1r. srate. ana
�'- 3oa -«�o. �6�-c�
�/ Contraa'udebte0ness unPaid as ot MMgag�
artent yeer date a( a
ray, sfate, ard LP oode)
� �'a � 33
b Ne app�ant the sole
�e¢a� «epuitawa wmen
❑ Yes ❑ No
witl��Nwn
�s me aoDe+�r in Qurs+ion: nnnuaM Assessee
Laie� �naertv ❑ !v�nuaM wss�sed
Dra�t�er \'0...����.....
�a�d nio. ...a.. 933.....
Does a�irant ovm poperty in eny oNer If yes, what munt�? Wtpt Ta�m
couMy m InC'ana? � Yes ❑ No
70
OUNTVAUDROR
Deduction in �he a N o.
2p 20 20 _ 20 _ 20 _ 20 20 _
Signawre d CamN AWitw Caunry Date (narvt�, daY. Y�d
I I We certfy undrs the penalry of perjury that Ne above aM foregoing infomiation is true and corte� and Nat the applirant is a residertt of Irdiana aM
owner I contract 6uyer of the aforementioned property on date apd��� is filed.
tip; sreu.
eseWleE
P4dress of aWwA¢Ed D�� (numGeraM sbeet �: sfate. anC Z!P code)
'y 7 � ��
� . o��e p�n, a�r, r�o