HomeMy WebLinkAboutMortgage_Youngson (3)-^'+ STATEMENT OF MORTGAGE OR CONTRACT����6$ oun 7ownship Year �
• POR DEDUCTION FROM ASSESSED VALUAT `—{
State fom1437W (R71 / 6-09) 1.J
�' Presvibetl by DepaRrnerit of Loml GovemrtreM Fnarce
wsrRUCnoNS: MAY 31 ZOII File Mark
�erty Farm Ned with:
To be lled in person or by mail with fhe CauntyAuditor or Counry Recorder of the county wh�re�'�ie��ygV ` Vbcated. �
Fil"mg Dates: 7J Real Pmperty: Must file tluring Me year Ior which Ne deductlon is wug� �� i unty Auditor
2) Mo6ile / Manufactured Homes rat assessed as Real Property: Must file dunng the v� months
bePore Ma/ch 37 of each year the deduction is sw�ght. ❑ Counry Recorder
GIBSON COUNTY AUDITOR
See reverse side for addiLOnal insfructions and qualifications. � ,
Key nimDer /
� esd� :Ja�a of intgest'!
Eifierent Nan Nat af app6tan� u�E'cate bebw.
rlame or mon�ayee «convaa seaer
AEdress of rtnrtgagee a contracl se�
-� p\�
naa� �Q ,,
— v, ;`\`, �, � (�
Dces aV . "• ��.i��
muntY i�
a;o ....
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D¢dutlid� a . _.c amOUN of.
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I/ We certify unCer the penalry of peYury Nat the abo�
owner I contract buyer of the aForementioned Property
7'lJ� —W1/• � i�pp,0 RecoNram6gr' PagenumEe�o
( O
fehtedness unpaid az of Mortgage / ConUac['vWe6ted�ss unpeid a5 W Is Ne epplirent Ne sde
O^ o O^ date of appGfation Mgal o,� o
./ v Yes No
If awneE wiM someone oNer Nan spouse, iMicate wM wMm
Is ihe p�operty in QuesUm: MnuaDyl�ssessetl
❑ Rea� aoPeny ❑ n��ny w�d
NTat Tari�g DisIriC7 I Has Uis Aedu`Yim Ceen re9uestetl m PmpertY
ror wrtent yeaR n vrs
❑ No
20 _ 20 _ 20 20 _
Counry Date (momh. daj�,�+es� j / / /
� CJ `rJ
(oregoing infortnaUon is We and correcl arW Nat the applinnt is a resident of Indiana and
te applicatlon is filed.
lr ' "vv—� cN1ti�
ent atltlress of applicant umber an she�et c`ity, slafe, arM?� ca
b�-l) .�- �i�'S' �Y, 1"(iv
ulha�vCE OY dtdy ezecuted Pov.er of Fttomey rn by IC 61_ t-12-0.7
of aW�u'ved perewi (numbera�M sbeef, cily, sYdfe, anC ZIP code)
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