HomeMy WebLinkAboutMortgage_Flick^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ovmship Year
:.—..
s FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R71 / 6-09)
S�'` , f Presaibetl by DepaMient of Lowl Govemment Firunce .
ile a
INS7RUCTIONS: F� fl� �:
To 6e filed in person or by mail with the CounryAud'ROr or Counry RecoNer ot the county where the property is located.
Filirg Dates: 1J Real Property: Must file durmg Ne year for which the deduct'an is soughf. ����tQ�d'rtor
2) Mobde / ManuFactured Homes rrot assessed as Real Property: Must file dunng the hvefve (72J months �
before March 31 o( each year the deduction is snught C.'4`-� er
See reverse side 7or addifional instructuns end qualfications.
qpp5ta (owrierorcmaactbuyu-seeresnictionsmre vde) . GIBSON COUNTY AUDIT
Istriq Key �wm6er / leg I description Rem�d number Page numbei
-i ,v�-aoy- 000, a.�3�oz
vaht c( real propertY as d �9a9e / Contratt'vdrbtetl�s unP� as W Mori9a9e / Cantraa uMe d af Is Ne aPP�^� ihe sde '
Mart�t� 7. wmin )�ar Marrh 7, curtent ynar date ot avPGptioncV`%� h��6� � a eWilade bwneY?
❑ Yes ❑ No
If no. what Is his / her exatl share of interesi? 1� ownetl vriN someane other tl�an spwise, i�icate wM wtrom
If name m remd a QClerent Nan Nat W aPP�^�• rtmd'uate bebw: I5 Cie P�7ertY in Question: MnuaOy As.^,e55e0
/', ❑ Rea� arovertv ❑ iarmuaM As�sed . . _
Nartre oi mOrtgapee or Wntred
�'
Address o1 nwrtga9e
Name ol assignee or a
pGEass W assgnee (nun.
5 /�`+(
ooes a.a�Wkam own w�PenY
countYmlrW�ana? r
amour.
20 _ � 20 _
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�t munp? Whal TaAng Di /a � �
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couNn nuoROR
20_ � Za I p_ I �- � �-
-vgfunne N�wmry_AUtliiw Caunry Date (rtmlh. EaY.Y��)
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I/ We certi(y under the penalty of �ury that the a and foregoing infortnalion is We and correct arM Ihat the applirant is a 25ident o( Indiana and
owner I contrad buyer ot ihe a(oremeMioned prop on date application is filed.
Sigrew (owrier's fu0 reme) • trdie (rtmth. daY. Y�)
/ �
FuOtesident atldres oj,a (number anE sheet, tlry, s e, ard e� �� 1, �� �
� �L N
Pelson auNoraed Gy dWy ezecuted Power WvneY m by IC 61.1-12-0.7 �� (�W. �Y. Y��
Pdtlress of a�thor'ned Ve� (numbel ami street cdy, slate. and ZIP ootle) .