HomeMy WebLinkAboutMortgage_Harrington^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
: . " �• State Fortn G3709 (R11 / 6-09)
�' � Pr¢soibed by DepartmeM of Lnwl Goremment Firence
File Mark
�srnucnoNS: �IAY
�:
To be filed in person w by mail wiN the CountyAudROr or Counry Recorder of the county wheie [he property is locat
F7ng Dates: iJ Real Property: Musf 61e dunng fhe year /or which the deduction is soughL County Auditor
2) Mobde / Manufactured Homes rrot assessed as Real Pmperty: Musf file dunng the fweNe (72) months ���
6e/ore March 31 of eacA year the deduction is sought. ounry Recorder
See reverse side for additional instructions and qualhcations. G IBSON COU NT
App�rant(ownerormntrartpyer-seeresfiu;ensoA�eversesiAe) . r� I 1 _.�
a�sud �n,e d ma� �nr �, a
Mamh 7, nrtreN Year
rc�.�ian�ine��e�ora
If �wne m n.md 6 6YerPnt than Nia
rya�y p{ �9�� or contract seller
nddress m moreyaqee «mno-aa seu
Name of assip�ee m Whe+ownar or 1
AdCress of assignee (number aM sd
y �vm,n« � lega�aesawtio�
V
Mortgage / Ca�traa h
Marc� t. artent year
�n
aPPGCant. mduate 6elaw:
n ane stree4 �Y, sbte. +
_r M mortga9e
cdy, slate, arxf ZIP catle)
xEn¢ss unpaid as W Mortgage I ContraY uWebtedness unpaiC as d Is Ne appfirani the sole '
date of appGwtion kgal w equrtade ovme(1
Q � '" ❑ Yes ❑ No
It owrre0 wiN someone aMer ihan spouse, iMieate wuh whan
• Is me woaPm m Q�e51io�,:,N�uaoy,�s,¢ssea
221 ProPeM1Y ❑ ilrmualhl A�ssed . . .
Dces applimnl own pfoperty in any oUer If yes, whet muntyl I I Mas Nis tleduc�ion been requwteE on property
munry in Indena? ❑ Yes ❑ No far arrent yeaR � Y� ❑ NO
�
COUP,'
Deduc6on eppioved m the amount of: I
20 20 _ 20 2� I 20 20
SigreWre of Camb Auditor Caunly Date (monlh, daY• Y��
I/ We certify uider the penalty oi perjury tl�at the above and foregoing infwmalion is true and cortect arM Ihat the applirant is a resident of Indiare aM
owner I contract buyer of Ihe a(orementioned pmperty on date ap0�ication is fiied.
�._....�..... �......eh en „�,�e� /1/ / i _ L1. Date (monfb. daY. Nea�
t
Pelson autM�rzetl Dy OWy esecuted PoMer W AttorneY or by IC �` 7.1-12-0.7 I�� (�h. �Y.
Pddress ot eWq�'veA persai (numOeraM sbeeL cdy, slate, and ZIP mCe) .