HomeMy WebLinkAboutMortgage_Vaught""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ = FOR DEDUCTION FROM ASSESSED VALUATION
• State Fam C3709 (R71 / 6-09) -� �� � � ��
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INSTRUCTIONS:
To be filed in person w by mail vnth the CountyAUditor or Counry Recorder o! the county where the property is located. F��
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FiRrg Dates: i) Real Property Mus1 file durirg the }rear (or which the deduction is soughL � Coun Avditar
2J Mo6de / Manufactured Homes rwt assessed as Real Property: Must file dunng the nvelve (72) months
before March 37 of each year the deduclion is sought. ❑ County Recorder
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See Ieverse side for addifional insLuctlons and qualifications. ..�'"�� '"'" �
nppricant(owneroroontrartbuyer-see mreVZrse - G!BSON CO�NTY AULITOR
Ta ' �_. ..�. Key.�wmbe�le�al dewip �n _ Remd numCel Page numbu
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I�rdNe cQ 2al propn:y as d
axmrt year
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Name of moripagee ar mntract se9er /� �//� � U �
��Y
ACtlress ot mortgagee w mntrad se0er (mimber aM sfree4 �y. state, erd LP
Name of astignee w othrf a ..J /1 /`V/" 1,)n� �/
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AdEress oi assignce (numbe
�a�t��� o�-yv3�
cowYV in Intliana?
20
0
in Ne ar..__... _..
20
ceN'fy under Ih natty of
I mntract Du f the afor
s unpaitl as of Mortgage I ConSact mEebteCness unpa0 as of Is Ne appfxant Ne sale
aate of appGCation 1eg31 «eQuitade ownefl
O ❑ Yes ❑ No
If ownad with someorre dher tl�an spouse. indimte with wtwm
Is Ne praperty in puesOm: Mrnia�yl�s,u55eA
eal PropeAy ❑ MnuallyAssessed
, Tav�g �istrvl� , Has Uis a
far artent
�i
20 _ 20 _ 20 _ 20 _ 20
Caunry Date (month, daY. Y��
the above and foregoing infomialion is We and mrteU and Nat the applirant is a resideni of Indiana arW
D�oPerty on date appliralion is filed.
F f II re4tlent aEdress of appfidnT(wmber aM shee4 mY.. �te, antl Z/P code)
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Person auNOr¢eE Gy tluh/ executed Power o(Attarney rn by IC 61.1-12-0.7
AEEress of auCror¢ed pelwn (number aM strect �+}: sbfe. and LP cnde)
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