HomeMy WebLinkAboutMortgage_Doyle (3)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 7ownship vear
_. ; FOR DEDUCTION FROM ASSESSED VALUATION
Siate Fortn 43709 (Rtt / 609)
�' w. � PreStnbeO Ey DeP��ttl of Lnral Government Firence
Fle Mark
INSTRUCTIONS: AU
To be filed in person w by mail wifh the Counry Auditor or Counry Recorder o! fhe counry whele the prope�ry is located.
Fil'mg Dates: 7) Real Property Must file durirg the year for which the deduction is soughG � Counry Auditor
2J Mo6i7e /Manulactured Homes not assessed as Real Property: Musf file dunng fhe fwelre (12) months /!�
6efore March 31 0! each year Ne deduction is sought. ��'+c,'qunty Recorder
GIBSON U
See reversa side for addifional insfircGons arrd quali�ications. ITOR
AppGfa^t (o�mer orcmtrac� 6vye� _ see resLictiwis m m�erse side)
Ta ' Distriti � Key rvyfiCer l iegal desaiplion Recofd num6er Page numCu
�- _ o - dna.�7 -oa-8 0 9 3�a
AssesseC veWe d� p(apaty as d Mwtgage / Contraa intlebteEness unpaid as of Mongaga! ConSaa mdeMedness unpaid as of Is Ne appi&ant the sde
Mart�h i, anP1tt yPar Memh 7, artent year tlafe o/ appGtation legal w epuitable wmefl
I ❑ Yes ❑ No
11 ro, what a tds / her esaU share of interest? If awned with someorre other than spouu. irMkate wilh whom
If riame m rtmd a QAlerrnt Nan that of aGP�t h�dicate Oebw. s prapeny m Question: MnuaM AcsesseE
Real Properly ❑ Mnually Assesse.d
f•"i�[•'':i
!G".'J'.e.-c—_.�.'D
or oNr! awner or hdder of mortgage
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L �dy. sbfe, arW LP code)
AdEress ot assignce (numbar eM stree; ray. slate, and LP cotle)
Dces epplifant own pmperty in any oNer
oowLLy in IMana? r-i _ _
What Tarirg DisGicl7
COUNTVAUDROR
20 � 20 _ � 20 _ � 20 � 20
Caunry
Dra�vcr NO...o.�.CQ`�.......
Card I�'O. ...�� �
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� �Sa,as�.
20
�Y• Y��
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I/ We certify under Ne penalry of perjury that the above and (oregoing intortnalion is W e and correct and Nat Me appGnnt is a resident of IMiana arM
owner / mntraa buyer of Ne afwemembned property on date appliption is filed.
Sqfawre (owne/s firo name) Date (monrh, day, yea�
ary,
Per•,on author'¢ed Gy dWy ezewced Po«er of Attamey a by IC G7.
Address of authoraed person (num0er aritl sfreot.
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Oate (monM, daY. Y��)