HomeMy WebLinkAboutMortgage_Dickey^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year y
,_ .+ FOR DEDUCTION FROM ASSESSED VALUATION
. . , .Sta[e Fortn 43709 (Rt t / 609)
, I Pasaibe0 Cy DeP��M ol Local GovemmeM Fnarce
w.
ie a
wsraucnoNS: fl �����
b be �led in person w by mail with the CounryAUditor w Counry Recorder o/ fhe munty where the property is bcated.
Frfing Dates: 1) Real Property Must fJe durirg the yrear /or which the deduction is sought. unty Auditor
2) Mobi/e / Manufadured Homes not assessed as Real Property: Must file dunrg the Iwelve (72J monfhs
before March 31 o/each year the deduction is sought. n ecorder
See reverse side !or additional instrucGOns and qualifiwtions. G I BSON C OU N
t(owm� orconVaU buf(er- see rc9+�'.tiwlS w iaverse side) ce �, • �
i.���a�aasa
amm[ year
ro, what is ha / her e�ct share of inte�esR
�� �a
artept
�o
II fwne m rewN is dfiuent Nan Nat of appGCant'uMirate Cebw.
����a����,� _
ti
ACdress of rmtgagee or contracl seAer (numb
owner or holder ot mwt�age
�
i Recwd rwmDU P ae O��
- 0/-003. �o-oa�� oil
� indebtedness unpaid az o( MMgage I Contra�Y uWebtedness unpaid as o( Is Ne appfxant tlre sde
�eer date o( aGP�� kgal w eWkade omcl.+
`I OO d ❑ Yes ❑ No
�f ownee wiM someone aher ihan spouse, iMicate with whom
is me p�e�ry m a�PSam: a,rwaoy wcsessee
a--,�-�- � �� , � � L
�e. ard ZIP wde) �� �
AtltlreSs o�assig�e (number arM stree; ray. slare, a IP code)
r . SE ' a -
Dces applimm wm p'operry in anY �� It yes. what <
cauntr in ��a�ana? r-i _. r, ..
O�(i.4�
YAaI Taa� D"slt�?
a�rl-a8sc�
Has �his deCuctim Oeen reGUestetl m pmperty
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