HomeMy WebLinkAboutMortgage_Armstrong (3)P
'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
.-_,_ � FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 93709 (R71 / 6-09)
S,�,� f Presaibetl by OepartmeM oi lnml Govemment Financc
File Mark
INSTRUCTIONS:
b be filed in person w 6y mail wifh the CountyAudiror or Counry Reaorder of the counry wheie the property is located.
Fding Dates: i) Real PropeRy: Must file during the year Por which the deducfion is saughf. ,� �_�nry Auditor
2J Mo6de / Manufactu2d Homes rrot assessed as Real Property Must file during the fweAre (72) rtwnNs
before Malch 31 of each year the deduction is sought. ❑ ou�FYRemrder
Seareverseside7oradditionalinstructlonsarMqualifications. GIBSO UNTYAUDITOR
AppGram (owne� or b r- sea 'clions m reverse side)
�h..e� v� ' �ir.�.����
Key number / legal d
�-%� �(o-/l- /� ��f00-
YrealO�pertY d Mortgage/ContraUinde6tedness
yrar March 7, artrent yPar
If narne on rewrd is diRefait ttun iha
Name of mor(papee or conbact seller
Mdress of mortgagce
:(�traa se0er (number end svee; crty, stale, .
om�er or holder of morigage
ier&ndstreef,�j' sfate,anOLPCOde)
.,i N� I/„_�_
DoeS applirant own property in any �
muniy in Indrana?
❑ Yes
D�Lucoon appmved in tlre artaunt oE
som
Wha1 Tadng Di
R�-�7 �umeP,
uMebtedness unpald �a!
� O I �.
�-.�- � 5�
Page number /
PP���� �
equdade ovme(?
� Yes n No
zo �_ � Zo � ,a5,���.�
Syrenne of Cowry AW rtw Couny
C ///yyy''��I r �q
I/ We certify under the penalty of ry that Ihe e arW (oregoing infortnation is truF " I 11� I��^-
owner I wntrac[ buyer of the aforemeMbned pm on date appl'rcalion is filed. ��
y Sig (own fiA )
7\
/ '
�FiA `esident address U appGmnt ( ber antl te, a� LPmtle �
/2�155 3 tJ �HC " w
Person authp'¢ed by duly ezecute0 Power W Atmrtie or by IC 61.7-t -0.7
Address of auNOr'vEd pe�son (numberaiM stree; tlry, sfa(e, and ZfP code) . �,`
�