HomeMy WebLinkAboutMortgage_Dick (4)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS coun Township vear
_ s FOR DEDUCTION FROM ASSESSED VALUATION
:• Stata Fwm A3709 (R71 / 6-09)
S„u Presvi�etl N' DeP�M of LDtal Govemment Fnance
Fi
INSTRUCTIONS:
Fwm filed with:
To 6e filed in person or by mail wifh the CounryAuditor or Counry Recorder o7 Ne tounry whe2 the pioperty is located
Filing Dates: 1 J Real Property Must file durirg the year for whith Ne detluction it sotrt�hL AU G O�O�unty Auditor
2/ Mo6de /Manufactu2d Homes rat assessed as Real Pruperty Must Ae dunng fhe fwelve (12J months
6efore March 37 0/ each year the deduUion is soughG `�y� ❑ Counry Recorder
See reverse side (or addifiWnal inshuctions and qualifications. �'[6"'
� �����bY�������.a�� I_/J// n A 1 i� GIBSON COUNTY AUDITOR
Taa atrrin ^ I I Key ^num6er / I d p n
V • _ •O �K� ���
PssesseC vWUe d real 7o0�Y as W Mortgage /(TUdeh'
IMa�di i. amsn year Mamh � cy�m�
5!
tt �a, whal is his / her er.aU share at intcrest?
tl name m remttl is Eiflerent Nan Nat of appikan4 �inte bebw
Name of mcxt9agee ar convaa u9u `
Addtess W rtaryagee w mntrad seAer
w oNU awner or
�Y.
mort�age
and LP mde)
as of Mortgage / ContraG inEebteEn�s un0aid as d Is Ihe aPP��t Ne sde
Cafe af appGratim Iegal w epuitade mme(1
❑ Yes ❑ No
If owneE wiM mmeone other than spouse, i�inte with whom
Is the P�PertY in 9��: /�nualy Assesse0
] Real Property ❑ Mnually PssesSed
Dces appli�ant own poperty in any oNer If yes, what munt�/1 What Taang D"slrifY? Has N¢ Eeeu�on Ocen repue5leC on propMty I
munry'nlriaar�a? ❑ Yes ❑ No fwa'rentyeall ❑ Yes ❑ No