HomeMy WebLinkAboutMortgage_Wood"•� STATEMENT OF MORTGAGE OR CONTRACT IND ESS o Township Year
__ � FOR DEDUCTION FROM ASSESSED VALUATIO �
� Sfale Fwm 93709 (R71 / 6-W)
� PresaiEeC Oy DeP��N o1 Loml Govemment Financa
"' MAR 5 20 File Mark
�vsrRUCnoNS:
fo 6e filed in Y ry ry ty �op y� F°"" Ned wim:
personor6 mailwiththeCoun AuditororCoun Recorderofthecoun where�fhe a�located.
Filirg Dates: 7) Real Pmperty: Must fJe during the year for which Ne tleduction is sought. `\ �c� �ounry Auditor
2) Mobde / Manufac2red Homes nof assessed as Real Property Must lile dunrg the twelve772 T�Onthi
6eforeMaich3foleachyearthededuclionissayht GIBSONCOUNTYA DITOF2 ❑ CounryRecorder
See reverse side Por additional instrucGons and q�("�cations.
��or2ontrad b�mer - see bsf�iamnsaFi reverse sdelf / \ / . • �� .� .
arxssee �.an,e cf real aopemi � w
MarU t, arm�rt yra
II ro. vfiat s his / Mr e�d share of interest?
If name m remtl q Cilferen� Nan Nat o( appGc
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Or�uction approved in ihe amount of.
kg31 dasaiption
_ ia _O� —303-60�./77 —p
xtgag baa iM�tedness unpaid az of Mortgage / Contract inC�
ardi 1, �r� � date o! appfi�fm
If awned wiN sorneone dher Ihan
� beb�v
� 3
tata, aid ZIP code)
iwoe)
I( yes. whal munt/? NTat 7aarg Distnri?
COUNTYAUDROR
20 � 20 _ � 20
Sign20ueq�C6imty/Cu�itnr �^/"� ��
`iari � , /
I/ We certify under Ne penalry of perjury th
owner! contraU buyer of Ne afaementioned
la.c�
e and
on da
Page
az
� U Yes U No
spouse. indira[e wrth wMm
Is ihe P�GenY in Guestion: MnuaM Assesse0
❑ Real ampenv ❑ nnnua�N assessed
Eeen reQUestetl m praperty
20_ 20_ 20_ 20_
ca�� n oa� ��w,. aar. r��
�C.b�
g infortnalion is We and correU arW Nat Me appli�ant is a resitlent of Indiana antl
ation is filed.
s of �aa�/ [(.n^um�Der antl sheef, dfy, sfate, and Z!Pj )
� �t/ /"!nn/UG Sf >�'��+(e�oi�
Dy dNy execuieA Porer o(Atlomey w Oy IC Gl. t-12-0.7
xd person (num0er aM sbcet mY. sbfe, an0 ZIP code)
;�l 7 � �!�
Date (rtunN. AaY. Ye�