HomeMy WebLinkAboutMortgage_Edwards^`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ .� FOR DEDUCTION FROM ASSESSED VALUATION
. . �.• State Fartn 43709 (R77 / 6O9)
�' � PresaibeE by �epartmerd of Local Govemrtrenl Flrence
� File Mark
�NSTRUCnoNS:
b be lled in rson w b mail wAh the Coun Audita or Coun Recorder o! tAe coun where the m F«m Aed
PQ Y A' b �Y P PerfY is located.
Filing Dates: 7) Real Pmperty Must �e dun� Ne year for which the deduction is sought. 1�,o��
2J Mo6�7e /Manu7aUurnd Hwrres nof assessed as Real Property Must Re during the nvelve (72) months L� S 7'�
6efore Ma�th 37 ot each year the deduclion is sought. ❑ �^tY
See reverse s�e foraddifional instructions arM qual�catirons. GIBSON COU
MP��1( �Y9°^varl Duyer - r�resLrLOra oPlev� sde) '
�
1 v�ue d rrai {aoperty az oi
amvrt year
mher/ I desaiP� ��� . Rem number Page wmDer
_/�-oG - /6 �- �o - �� � G//
e/ Conbaa'udebtedrress unpaiO az of Mortgage / Cmva�Y mtlebtetlness �mpaid as o! Is Me appficant ihe sok
Mar . airtem year Eate o( aDP��+ '/ �gal or eWitade owneR
. �' j`�J /j� ❑ Yes ❑ No
�i M. Wi18� 6�I15 � i12f CNdf15�13fC Oi NiPlCSI�
If naznC On r¢Wrd'a NRerenl Ihan thaf of aGP��t'u�tlM3[¢ GCbw.
rla�re of �wne�9ee «m,o-x, sene� `/
�U /S
Address N rt�artga9ee w mntracl seller (num6er end stree; ciry, sfate, arM
Name ot assignee w othu owner or halder ot morigage
Atltlress of assvyiee (wm6eraM atree4 �Y. sfafe. entl LP oode)
Does applimm ovm propeny in any oUer It yes. what munry
counry m Ind'ena? ❑ Yes
❑ No
DeEUCtion approved N Me amount of:
20 _ 20 2(1 _
Sia(aNre of CamN AuOi�w
COUi
20
It o�med with somerne oUrer fhan spousA. iMicate with whom
,IySy{re PfOPQfI)'NVIIMLryf1:Mf1(ICOYAS52SSE4
y� Real RoPertY ❑ ArmuallyAsessed
!� r�o� r� nc v�.
W�at Tarirg Datrrl? _.I Has N_ dedutlion Eeen reauestetl m properly
_ _ _ � Yes ❑
Dra���er NO..'�.�.!!.-.......
Card \O. ...,�', 7,�.�....... p
3�
I/ We certify u�ef �he penalty of perjury Nat �he above and (oregdng infortnalion is W e and cortect arM that Me applipn[ is a resident of Indiana and
ovmer I contract buyer of the aforementioned property on date appiicatbn is filed.
/�/�_ l—E_t-� _ � - Iz
(numberantl stree(, city, slafe, ard ZlPmtle)
Pe�sm auNO�rzed Dy O�dy
ve�sa+ (n�mee. ana meet dN. sare, sne z�a wde)
Date fma�nN. dal: yea�