HomeMy WebLinkAboutMortgage_Hayden (2)"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ • FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R71 / 6-09)
�` Presoi0ed by �eP��n� oi lowl GovemmeM Frurce '
�«.
INSTRUCTIONS: J
To be (led in person w 6y mail with the CounryAuditor or Counry Recorder o/ Ne county where the pmperry is located.
Fi7ing Dates: 1) Real PmpeRy: Must file durirg the year (or which Ne deduc0on is soughG O
2) Mob�7e / Manufectured Homes �rot assessed as Real PrUperty: Musf file dunng the fweNe (12) months
before March 37 0l each year Ihe deduclion is sought.
See reverse side 7or additronal inshuctions arrd qualifications. C
MWn owneruwntrarYbuyer-seerest�ir�ons verseside)
Atsessed ratue d rnal paperty as d
Me�d� 7, Nmrt ymr
If no, what ts his / her exar�
m
Year
Counry Auditor
j ��i,ry Recoraer
� GIBSON COUNTY q� j� o
y number / legal desaiption Remrd umber Page number
— D - eZ - 00 �ODO • � �p-O .ZO �0/,�- SO S S
Mortpage / Contract indehteEness unpaid as of Mortgape / Convarl intlebtedrpysyn paid�s d Is Ihe appaant Ne sNe
March �, arm.nt year aate ot aoo���+ 1.3 b� 3 O U �°� ��e °N"�'
❑ Yes ❑ No
est? tf avmed with someone dher sGa+�, iMicate with whom
aPP��l ��ipte Delow. Is ihe prapeny in 9uestion: Mnuelly Assesscd
� 1-1.Real RoceM I—I MnuaM0.sse�ed
m nnrrgagee «mnvan seuu
,1en�.ftv�t/1 C • U
a of rtiarh�agce or mntracl seDer (number aM streef, crty, sbte, aM LP cade)
Name ol a"�nee w
wm pfoperry in any oNer
a� ❑ Yes
rtnrzgage
�hre, antl ZIP cotle)
If yes, wha[ munt�//
I No
WAat Taring D'abict7
D,��,�.��- ,. o....a. o.� :a .. . ..
Card \`O. ....,,J�, OSS
�I� U � MJ W .....
F7az �h's Oetlu�Yim Eeen reQuesreo �.i r.�.._., I
for wnmt yeaR ❑ Y�
❑ No
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