HomeMy WebLinkAboutMortgage_Boyd^`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
:._—
s FOR DEDUCTION FROM ASSESSED VALUATION
� • Sfate Fortn 43709 (R71 / 609)
�' � Presaibed by Departmenl of Local Govemment Flrance
F' e a
�STRUCT70NS: F� �� �;
To 6e �led in person or by mail wifA the CountyAudito� or Counry Recorder of the counry where the propelfy is located. � 1 1 ���„' n
Filing Dates: i) Real Property Must file dunng Me year for which the deducfion is soughf. v (�innty Auditor
2) Mo6Ae /ManulacNied Hortres rrof assessed as Real Properry: Must Sle dunng the hveMe (72) months
6efore March 310! each year the deduction is sought. C �—�ounty Recorder
See reverse side for addilional instmclions arM qualificafrons.
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A� re�e d r� P�D�Y a of AbrtaaBe � Ca,traa vde�E�s ��pad az w
Me�rh 1, avre�V yrm Matd� 1. artenl yPar
If ro, what ts his / her e�ct yare of infe�estt ff�
11 �ame m remd is tliRefart Nan that of appGpnt. ubifate 6elow:
Name oi mortgagee or mno-aa
Mtlress of mortga9re «contr
Name of assignee or other owner or hdder of nqrigage
(number antl sveef, dry, smte antl
14� �
property in any oNer
(nurtiber erM sbee4 �Ri: �re. aM ZIP code)
C:'•^3
of
20 I 20 I p
v • � —vi—
I I we certiry under the penalry of perjury t the above a i
owner / contrad buyer of the atwementi ned property on�
SignatuJ� (owners lull name) �
_ f-�.�� Q E KP .( n �/�
FWI resident adtlress of ap�rant (nu r antl street, dty, staf ae � 2
13a A1 T.Fr��-%��2`}�r',a� �r
Persm auUroirzed by CWy exeated Power af ALaney or �y IC 61.7-1
Address of authomed persrn (numbe! arM shee; ciry, sbfe, an0 ZIP
What Tad�g
GIBSON COUNTY AUDIIUK
R¢mrd ramber Page wmbe�
-D�8 / 3�73�
ontrari uMebtedness unpaid as d Is Ihe appfrant the sole
ation kgal w e9uibde owneR
� Q ❑ Yes ❑ No
: oiher Cu spouu. iMimte wtth whorn
�IsiM mG�rtYinVuesUOn:Mn�zMASessed
eal RoPertY ❑ A!°n�allY %�ssessed . . .
��y � Ky �t d - --
�iOC I��Zi,L l�
Y
�a - 3 83 � _
2� 20 2(1 _ 2�
Caunry Date (�h. daY Yea�
regoing infortnation is We and cortec[ arM that Ihe applicant is a resident of I�iana a�
applicatlon is filed.
� Date (monfh, day, ysa�
d�y 1�a�