HomeMy WebLinkAboutMortgage_Ferguson (3)—^'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun�
_ - FOR DEDUCTION FROM ASSESSED VALUATION
' smca r-wm a3�os (Rn i s�)
`..�. � a�PSCrfnea ey oepartmem or Locai cwemmem Frarre
INSTRUCTlONS:
To 6e l/ed in person or 6y mail with the CounryAuditor or Counry Recorder of fhe counry where lhe property is located.
Filirg Dates: 1) Real Property Must file dunng Ne yrear fi� which the deduction is sought.
2J Mo6ile /Manufadured Homes rrot assessed as Real Property Must h7e d�ring the twelve (12) months
befora March 31 af each year Ne deduction is soerc�ht.
See reverse side for additional instnuUons arM quali�cafions.
_,
Assessetl rdue d 2al P�P�Y as ot AbR9age / Conbaa u
IMarth 7. aurent year Mart�h 1, a�rtem year
n �o. �i � n�s � � �a � a� ����?
If riame m mmd a dittrm�t Nan Nat of appi'ican� u�tluate Gebw.
�����a���� 513
Address of mort9a9ee v contrari seDer (numbri arrl stree4 �Y. �e. arN LP cnda)
rvama at asvgnee or aner owner or ndoer rn�ronc�age
naaress o� asvgrree �numuer areu suee; cuy. sraie, ano ur woe�
Does epplinnt awn property in any oUer If yes, wh[
appmvea ui Ne amoum of:
20 I 20 I 20
Co� �uditw
County Recorder
GIBSON COUNTY
.s3� aa� ��'�`
u Mortgage I ContraG mEeMedness �mpaid as d Is Ne a
tlateqE@ tan ,�.
U Vv�.
rc owud vrim sameme oarer Ihan
�oa F� RG u so �
y
I I — 30� �
� � U Yw L,J No
spouse. iMiqte w�h wfam
Is tM property in Question: MnuaOy Assesv.M
❑ Real Property ❑ MnuaOy Asessed
Modle Fiome OC 61.1-i
20 � 20 _ � 20
lul9on been requeSteA m propnny
eaa '—,
20
��ture of Coimb AuOiNr I Caunry I Date (r+vmh. eay,lea�
I 1 We certify unAer ihe penalty of perjury Mat the above and toregoing in(ortnation is true and corteq arM that Me applirant is a resident of Indiana antl
owner I contract buyer of the afaementioned property on date appiicatlon is filed.
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Person au0vaetl Gy CWy eaecutetl Power W AvaneY rn M I
Atldress of auUiaaed person (numberarW sbeet, al}; slate.
Da�e (mmfh. AaY. y3a�