HomeMy WebLinkAboutMortgage_Hale^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ _- FOR DEDUCTION FROM ASSESSED VALUATION
' � State Form 43709 (R71 / 6-09)
�' ,.,� � Pr�aibed by Oepatbnent ot Lod Co+emme�ri Fuiance �
Fil ark
INSTRUCTIONS:
To be filed in person or by maif witA the Co�ntyAuditw or Counry Recorder oJ the county where the properry is locat F� ���
Fi!'ug Dates: 1) Real Property: Must b!e durirg the yearlo� which the deduc�ion is soughL (�P R�S 2� �� Counry Auditw
2) Mo6Be / Manu/acfured Homes not assessed as Real Property Must file dunng the twelve J months
before March 31 o/each year the deduclion is saighf. �❑ Counry Recorder
C.�.
See 2verse ' /o( additio arM qualificafions.
� � re� � GIBSON COUNTY AUDITOR
��M�GY � ,� a0( / ' /O � �W � � 7 �j QpL num0er Page rwmCu
Ash�vaAiec(2aIVW�Yasof Mortgage/COntrau'v
� 1. armrt ym Martl� 7. Wrrent year
tl ro, whaf Ls his / tcer euG share oi interesi?
If'arne m remN's 6Rr1en[ tlan ihat of app8�nt, cd'uate Celow.
rUme or morniasee «con,rar� s�
AAdrass of rt�ortgagee w contraf3
AilE�essofassyne
Daes evP��mm wvr
munry in IMana?
20 _
Sigr�ature or Counn
I I We certify u
ownerlcontra
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FWI
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o-'
O
�
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� V `
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iuy exewted Power of Attnmey or by IC 61.1d2-0.7
persq� (numberaM stree; rity, stale, aM ZIP cade)
as d Ls Ne appOrant Ihe sde
ieg2� a e�uita6le Ov.�(1
n Yes n No
prlty in 7uestion: MnuaDy AuessN
�a�v ❑����N�
~/ / Co
n been reQUested m pmperty
❑ Yes ❑ No
20
rmth. EaY• N��l
t is a resident of IrMiana aM
mGh. Esy Y�a�
— /R — 1 I
�Y. Y��