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HomeMy WebLinkAboutMortgage_Higgins""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear _„ = FOR DEDUCTION FROM ASSESSED VALUATION • Sta[a Fotm C3709 (R71 / 6-09) S�.�. � Presmbe0 Ey DepanmeN of L.oml Govemmerrt Frianre '' " INSTRUCT70NS: To be filed in person of 6y mail wiN the CountyAUditor or County Recorde� of the co�nty where the pioperty is1qt�tp� F� ��� Fil'mg Dates: 7) Real Pmperty: Must �e dunrg the year (or which the deduction is soughG J t r 2 S ZQ County Auditnr 2) Mobile / Manufactmed Homes rwt assessed as Real Pmperty Must 61e dunng the twelve (12J monfhs 6efore March 37 0/ eacA year the deduction is sroughG '-y�/ ❑ Counry Recorder See reverse side !or adtlitional insVUCfions and qualificafions. p'� 6� ��. Ap�wnt (owner or conUaG buyer- see res4ict'ortc m reverse vCe) . __ _ . • . l_ i • • , GIBSONCOUNTY oistr�[l As� vd4�e d mal poputy as ol Ma�d� 1. arrent year 11110. Whdl IS h6 / h¢f EYdd ShBIB Of VIi@!¢Sl7 m n.md is Citfer�i Nan Nat af app6rant ���e Gela�r. „-.,,r'vCzT 5 , d rnortgags ar mno-aa _o� -.3o�-ooa. a�-o�8 5 act "uWebtetlness unpaid as W Mortgage I ConVari mtlebtetlnrss unpaitl as d Is Ihe appikant Ure sole year �ate of avP��� legal w eQURade oxne/? S /7 /) ❑ Yes ❑ No sbte. aM LP mQe) It owned wiM someorre dher Ihan spouse. i`Wuate wrth wMm perty in GueSCm: Mnua%PSSeSSed aropertY Qnm,�alNasse,ssed _�—_-- - Name af "� ee w oNU ownet or haltler of mortgage - nce�ess ot assi9nee (�umaerene sveet �: stste, and z D I':11Y C I' � �..��.V.�. ...... Does e�imnt am property in any oNer If I^ 1 Has this tletlutlic mumymi�eera? n.,_ n.._ C:7Cv \'�. ... ...lY.......... raa,rten�vean icban appmvea v� ure amoum ot . 20 20 2Q 20 _ 20 Counry r.i� �� ��v�v Yes ❑ No Oate (monlh. day, yEa� 20 I/ We certity unde�e penalry of perjury �the above and (oregoing infortnaUon is We and cortecl and Nat Ihe applirant is a resident o( Indiana arW owner I mntract buyer ot Ne afaemention property on date appiinbon is filed. ` ' rewre (o�mer's hAreme) _ Date (nmth. EaY• Y�+) x � Full Rsident d appWant (numberand , tlly state, ard Z�P mde) v �'!I Addmss of aWiwtred prlmn (numberantl stree; ury, sla�e. 142-0.)