HomeMy WebLinkAboutMortgage_Fox (4)°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
slate Fom, oa�os �Ra r z-0�)
S � Prasmbed by Department of Local Govemmen� Fina�e
ar
File Mark
IMSTRUCTIONS:
To be filed in person or by mad with the CountyAuditor o( the courtty where the propeAy is lowted. F EB , 3 2��9
Fd�g Dates: i) Real Property: Dudng fhe 72 months be/ore June 11 0/ fhe year the deduction is to be elfective.
2) Mo6iie Homes assessed under IC 6-1.7-7: Behveen January 15 and Mard� 2 o7Me year the deduclion is fo be eflective.
See reverse side (or additional instructions and qualificafions. `�� �� �
see
.�y�■�•_a•�
is ns � ner eza�x stere a irrteresn
I if reme m record is
or
GIBSON
_-� 3-a o 3. S8�'-o a2
aqe � co e/d�{�/ unpaid �as /ot �nlarcl, 1. �s ure appGra�t u,e sde �ega� «eq�ritade wvnen
�� I �kPOVV ❑Yes ❑No
1 with someone dher Ihan spouse, mdifafe with wtiom.
� Address or mongagee a canvaa seller (rwmDei and 9reeC cry, stafe. and zIP crode)
� Nartre of assgrrea or dher owner a hdder of mwigaga
Address ofassig�e
Does a
countY,
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D�-�„���- �o....
C:ll'C� �0 ...�� ^� ......
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IITS .nfr'�.
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� Signature of Caunrylwtlitor
? VJhal Tadng OisUic
COUNTYAUDROR
20 _ 20
Cwnry
Is Ihe prapaM in queslion:
❑ Real Property ❑ Moale Home
�duqion been requestetl on property
Y��
❑ Yes ❑ No
20
2� _
I/ We certify under the penalty of �ury that fhe above and foregoing infwmation is true and correct and fhat ttie appGpnts was / were a resident oi
Indiana and er oi ihe a orem �med property on March 1, 24
Sig�ahue ( Nl�me) Dafe ( lh. tlaY. �
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F .,a ress f iraM (n be` and street cCy. stale. aM ZIP mde) ��
'"( evt U ��l �
Pason aulhar¢ed by duN ��ted Power ot A1�orney w by IC .1-72-.07 Date (monN. daY. Y�A
Address of author¢ed person (numbei arM sheeL cdy, slate. arM LP oode)