HomeMy WebLinkAboutMortgage_Cutright"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSEO VALUATION
SMate Farm 43709 (RB / 2-07)
S u» � Ptasrn'bea bY Depanmen� of local GovemmeN Firw¢e
ile Mark
INSTRUCTIONS:
To be filed in person or by mad wifh Me CountyAuditor W the comrty where the proper(y is located. AP R 0 9 2��9
F3ing Dates: i) Real Propeity: Dunng the 12 marMs before Jwe 77 d the yea� fhe deduction is to be eRecfive.
2) MobAe Hames assessed,mder IC 6-1.1-7: 8etxeen January 15 and March 2 of the year Me deduction is to bs eRecfive. ,/
See /everse side /or addiSonal insWCfions and qualifications. ��rn ,C���.
pppicam(amu�m buy ^seere9ncliuns�i ver�ide) .� • �� G�BSONCOUN
ralue ot real
_ Keyrwmberll tlesaipUOn
- 03- 0 , 83-��'
as n�a„3, ,. �n ra,r �ye i com�aa ��eewueaness w�v� � or n�arcn ,.
arteN year ' / �-71
� UU ��
ve af intamsR If avned wGh sartreme aU
Ihat M applicar0. irMiote belo.v:
rtrn�agea ar carqracl sallar
Address of mortBagee a canirae seller
stafe,
Name of assignee d alher owner n hdeer a mongege ,
Address of ass9nee (rnenbu aM s6ae4 aY. 9ate. end LP mde)
��w���„�ro���� LF.su.�2c,itr�Gd�T -
courrty in Indana7
❑ Yes ❑ No
p D
amamt ot.
�
D �--5y�
u,e sae
❑Yes � No
spouse. �mte wilh whom.
Is Ihe prapeM1y in que.^.tim:
❑ Real Pfooertv ❑ Moble Home
20
nem, .eyues�ec o� property
❑ Yes ❑ No
2�
I/ We certfy urWer the penalty of perjury ihat the above and foregoing infortnation is We and mrrect and ihat fhe appfirants was I were a resident of
Indiana and owner W the afotemen6med property on March 1. 20
signawre (ow{iers na� nerQe) . � _ oate (monm. ear r��
stafe, antl Z!P cade)
Persun aWhor¢ed by Euly erzewted Power af Al�amey or by IC 61.7-12-.07 _ �I oa� (monu,. aar. y��
Pddress of aultror¢ed person (numbar ard sbeet rdy, sfate, and LP oode)