HomeMy WebLinkAboutMortgage_Gonzales (4)""* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 63709 (R17 / 6-09)
�' 1 PresaibeE OY �Partmen� o(Local Govemment Frence
INSTRUCTIONS: -
To be filed in person or by mail with [he CountyAUditor or Counry Recorder of fhe county where the p�operty is located.
Filing Dates: 1J Real Property: Must fiIe dunng the year /or which the deduc�ion is sought ,
2) Mobile /Manufactured Homes not assessed as Real PropeRy Musf file dunng fhe fweNe (12) months
before March 31 of BacA year Ne deduclion is sought.
See r9verse side for adtlifional inaWCtnons and aualilcations. A �
Ases^,ed vah�e cS2a1 poperty az of Mot�gage/ Cont
MarCh 1. anem year MaRh 1, an�en�
t�9
/
If m, what ¢ his / her eraC share of intrlest?
11 twrie m remrtl a Qifferenf Uran Nat o( aPP�. �dipte Eebw
Mame ot rtiortgagee n
n
m ass�ee w rom awner or naan a�^—
_
�d�
�
mun
Draua
2(7
sLreC �: stam.
D�•a���er10•.aOC��,.... -
��a�?.......... 7
Card 10. .. ..... •
,��Sq�-j S �. oD
_. I 20 1
I I We certify u�er Ne
owner 1 mntrad buyer �
I�re (awne/s /u0 �me)
20
�
If
wnat ra,a(g o�ma7
�
2 �[�nryAUditnr
❑ Counry Recarder
GIBSON COUN7Y UDITOR
RecoN numbp,� _ Page number� �
lJ�! 5
'uMe6tedness �mvaid as d Is Ne ePP�t Me sde
legal w equitaWe o�vneY.+
n Yes ❑ No
Is iM P�GartY in Vurstion: Mrn�aDy Asctsed
❑ Real Roperty ❑ Mnuaily A�ssed
Fias Ihis deew]ian oeen reauztled on piaperty
Por wrtent Y�n r-� .. r—�
20_ � 20_
/ Y .� D I �n / o � .FJ Vtif �/\ I Date (monN. �Y. 1e�� _�C
Q�
Mat Ihe bove arW foregoing in(ortnation is We and mrte�Y arW that the applipnt is a resideni of Indiana arM
ned D rtV On date applicalion is filed.
ard ZIP mde)
Person auttn�¢eE by tlWy esecuteC Power of Aftorney or by IC G7.7-12-0.7 I Date (nanih. tlay.
Pddress of authoived pr�son (number aM sfree; ciry, state. anC ZIP cnde) .