HomeMy WebLinkAboutMortgage_Noe (2)^'� STATEMENT OF MORTGAGE OR COIVTRACT INDEBTEDNESS Coun Township Year
,_,. - FOR DEDUCTION FROM ASSESSED VALUA [�1 N� ��
• Stata Fortn 43709IR71 / fi09) � �
��` � Presaibetl bY DePa„�(tl of Local GOVemmeM FuNnce
� File Mark
INSTRUCTIONS: APR 3 O ZOIZ
To be filed in rson w b mail with the Coun Auditw or Coun Recorder o7 the coun where the F� �� ���
ae r h N b w�aem rs roca�ea.
Fil'mg Dates: 7) Real Pmperty: Mus[ file dunng the yearlor which Ne deduction is sqg1�.. �� f�nty Auditor
2J Mo6de /Manufactured Nomes rrot assessed as Real Pruperty: Must fiie dunng (72) rtanths
before Maich 31 0/ each year the deduction is sought County Recorder
See reverse side (or adUitbn� instructions and qualifications.
GIBSON COUNTY AUDITOR
AoefrantlawrmlarmntraCb r- rcsUirlionsmre�xrsevtlel "' _ �
�isusscC ra5re Ureal P�Y a ot
A19�rh 7. aamnt yrar
�i Iq. W�Id� 6 �16 � �1Ef C1di 5�1210 Oi IIIi2IP5l�
If name on record is ddfemnt Nan �hat of aPpl
r�� or�� «�� ��e�
/
Deb�r
ot nfdigagce ar conRaa SWer {numcer ena suee4 �//JC �+a. alm ur cm
ryame m assgnee or omrl owner w nwoer
PdE2ss ot x�� ee (number aM streef, tlry, sbte,
Dces applicant avm MoPenY
�� �� i�a�aa �
approveC m ure artwm or.
20
sg�an,re d c�n wa��r
0
n yes. xnat munry.
No
20 _
�{ —OC�. /�%-0d�1 �D/c
unpaiE as of Alongage / Contraa iMehtedness unpald az of�
tlate ot appGCation I
.'tt avmeG xiN someane ahrl tlun spouse. iMicate vAN v
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C�p� � �n S � �e� s
O � , ✓
- � y5;�.�i
COl
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ao�a -
I I We certify under the penalry of perjury fhat the above and foregning
owner I contract buyer of the afwementioned Droperry on date appiicat ����
7rewre ( h!I )
�numoer ana snaer, ary, srare,
autho�rzed by EiAy exeated
AOdress o( authoraed perso�
ana [�r ooae)
iitade ox+reR
Yes ❑ No
��
�
teE m prapeny
�es ❑ Nc
20 _
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: of Indiana ard
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