HomeMy WebLinkAboutMortgage_Tedrow^'� STATEMENT OF MORTGAGE OR CON EBTEDNESS Coun Township vear
__ „ FOR DEDUCTION FROM ASSESSED V�AL�T�� ��
State Form 93709 (R71 / 6-09) g�
,' �.r � PresaibeC by DeV��N of Loral Gwammenl Frence
File Mark
irvsrRUCnoNS: DE� 2 8 201)
To be filed in person w 6y mail with fhe CauntyAUditor or Counry Recoider o/ the counry where the pioperty is located.
Fi7ng Dates: 7) Real Property: Musf file durnig Ne yaar for which Ne deductioru�3.5otigW
2J Mobde / Manu7auured Homes not assessed as Real Property: Must file dur6r�g Ne eNe (72J months
6efore March 31 oleach year Ne deduction is saght.
GIBSON COUNTY AUDITOR
See rever:�g side for addfiional instnmtbns and qualiFications.
Key (wmber / le� d Crion
�r�- ia-o7-ioa-c�o�.is �
Pssesse0 va4ie af mal qopaty a d Abngage /
Marrh t. qrrenl year Mgrtli 1. a
(w, wta� ¢ Itis l lrer exatl shara ot inte�est?
If narrie m
Name of rrortgagee or crntract se0er
�eb�Y
Address of nqrtgagee w canbaa seCer Inembei and street �:
Name o( assignee w oUier ownm w tqlder of moriga9e
tlty, s,ate, aM
Does applimm wm praperty in any dher--
munry in IrWiana? D .. �
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Fwm �i ed wiN:
unry Auditor
❑ Counry Recorder
az
I( owned wiM someorre Mrer ihan sPWS�. Iridirate weh whan
'e)
t munq? What Tadrg D�sinct?
COUNTYAUDROR
_ zo_ 20_
��
w eWrtade amef!
❑ Yes ❑ No
Is Ne ProGenY in 7uesUttc MfwaM Assessed
�� Real RoPertY ❑ ArmuallyAssessed
oeen reGU�tea «� v�ov�r
�_
Date (ma�M. daY Y�a�)
20_
I/: �ie penalry of perjury that �he above aM toregoing infortnalion is We and cortecl arW t�at the applican[ is a resident of Indiana and
own ..,ea buver of ihe afaementioned Dfoperty On da[e appliration i5 filed.
slate, antl
Person autlror¢ed Gy duh/ executed Power of Attomey or by IC Gl. t-12-0.7
per,m (number aM sbee(, dry. stale, and
�Y.