HomeMy WebLinkAboutMortgage_Hettenbach^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun�
� FOR DEDUCTION FROM ASSESSED VALUATION
`r_"' - ,.
State Fortn 63709 (R11 / 609)
� f p���pyd py pe��nl of Loral Govemrtrent Firence
�STRUCTIONS:
To be filed in person w by mail wifh the CountyAuditor or Counry Recorder o7 the counry whe2 the property is located.
Fifing Dates: 1) Real P�operty Must fi!e during the year fir which the deducfion is soughf.
2J Mo6Be / Manufacfured Hortres rmt assessed as Real Property Must file dunng the M1velve (72) months
6efore Ma�ch 310/ each year the deduction is sought.
See reverse side (or addifronal insfructlons and qualificafrons.
sm mea wal,: —
� m9 ¢f}?Qia,eno�
❑ _ County Recwder
qppGra umntrarl6uyzr-seere " mreversesiie) GIBSON COUNTY
T' isUrci KeY rvunbes / kgal desmD� Reco�d mimhrl Page wmEr1
lUC.m�e�� �. -/a-o8—�o3-cr�i, i��-o�8 3�oi1. Yc�
p,y�,y v�we y real qop¢r,y as pt Mortgage / Contract'uWe6tedness unpaid as of Mortgage I ContrarY irMeMedness unpaid as W Is �he appfirant the sole
Ma�tli 1. au�enc yar March 1. wrtent yeer date of apOGfation legal ar equitaNe ovme(.+
If rq. wtut is his / her eYac1 share of interest?
If �artie on remrE 5 N9erent Wn ihat at aGP��t• udi�ate hebw.
Name ot mort9a9ee ar cmtracl uller �� /
L
qdd�css ol rtartgyg� a �ontrad se0er (numbe� and snaet, cdy, sate, aM LP code)
Name of assionee w other wrt�er or hol0er of mortgage
AEtlressoiassig (numbera
� GJ
Does epplinnt av.n property in any
cou�LLyinlndiaiu? i�l ..'"
�
amount of.
U ❑ Yes ❑ No
If owned wi� s teone dher tlan spouse, iMirate wRh x7wm
I5 Me propeny in QueSlion: MnuaPj AsResSeO
❑ Real Property ❑ Mnuallyl�ssessed
Mo6��e Home (IC 67.7-7'.
state, aiq or oe)
, 3 � Bt-.z�
I( yes. what counp? Whal Ta�dng Distrkt?
I No
6UUIV I T AUUI IUK
3�y
f�251�16 �IIU%Y1 �CEf1lCQUESiE� M pfOPElI'/
M aurw Yea/? ❑ Yes ❑ I
� E%7�EV [�I�,�, � � �
zo- � z°— o�Ul�2 - o29c� O
�
�ruwre ot CamN nuaaw
C • T • �'Lt-eti^
I I We certiry under ihe penal
owner I mnVact buyer of the
Pe�son auNOraeO by duy executed
AOtlress ot aNhw'veA persan (num,
Counry
aM foreguing intortnalion is We and correa a.... ___
n date applicatlon is filed.
riry, stat na [Ir cme� .
r� n c� fuh
, a �, �� �,.,-,z-0.�
trty, state,
�
Date (rtpnlh, Eay,
0