HomeMy WebLinkAboutMortgage_Koss"'r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
__ FOR DEDUCTION FROM ASSESSED VALUATION �
- � State Fortn 43709 (R71 / 6-09)
�,.,� PresmCed Dy Departrtcnt o1 Lodl Govemmertl Flrianca
File Mark
INSTRUCTIONS: c�
To be filed in person w by mail with fhe CouniyAuditor or Counry Recorder ot the counry where the property is located. `� E �
Frlirg Dates: 7) Real Praperty: Must file dunrg Ne year Por which the deduction is sought. � Coanty Audimr
2) Mobile / Man Wactured Homes rat assessed as Real Property: Must fiie dunng the tweNe (72) months � �
6efore MarCh 31 0! each year Ihe deduction is sought. G nty Remder
/
Seereve sideforaddftionalinstiuctbnsandq lifications. GIBSON COUNTY AUDITOR
Appl�a u+ie�acontrd�bN'er- verseside) .
�
T' s�ct Y numEer / le9al tlesaiPUOn Rem�d numba Page n?umbu
� .l . __ w.. fi�AVIJ .')./ _! � - � %' �'07.�— �� � ' � eZ g � 0 �J.��
Asse�sed vahie d mal P�P�Y ��
Ma�d� t, amrn year
11 no. what ts tus I trer e�a share a
e / Cantraa u
. arterrt year
If rwne on 2coN a dA(erent Nan Mat of appOcant,'uMirate bebw.
Name M rt�ortg�ee or mntrarl se8er
Address d rtiortgagee w contrari sn�
Nama of asvgnee or � owner w h
Dces a�pfi2rR ovm property in anY Whe1
cou�uyinlndena? ❑ Yes
�.: .�-,
�
atreeG ub. ffi�.
��.a�
amouN m
20 20
rI/ We certify urd�f Oie penatty of
owner I mntract buyer o( the afor
ks��,R co,,.�,� „�,�
1 u0 revtlent aEdres of app�irant (numbe� antl stree4 �: sbte. and LP m
�. �gk S�, P�;.,�
oy e�ay �ew�ee aov.�e. or nvd„er a M�c s�.�-iao.�
.id person (number a� snee; city, state. anC ZIP oode)
unpaitl as d Mongag�� mtlehtedness un7aid as d � ���
❑ Yes ❑ No
tl owned wit� someo� otl�er Ihan sD�T�. trdkata xiM whrnn
IS the Pm7ertY in Ourstion: Mm�aDY Assessed
[�a� �oaero ❑ rv�!,aq!ws�essed - -
, � � 3;
Tavrg Datrzl7 Nas
tm c
COUNTV
20
the above arW foregang infortnaUon is t
property on date applicatlon is filed.
AEdreSs
���o�
❑ Yes ❑ I
Drawcr i1'0..��11�.......
Card i\'O. .....).�j, �
� ��$1,�3y. � •�......
oa� lmornn, dar, r�n
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