HomeMy WebLinkAboutMortgage_Riley (6)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court
_,_ � FOR DEDUCTION FROM ASSESSED VALUATION
. s�ace Fo�m as�os (R�i i s-w>
� wp > presrn'ped by Oepartmem of Lnml Govemrtrent Fnarxe
�NSrnucnoNS:
To 6e filed in person w by mad wRh the CounryAUditor or Counry Recortler of the counry where the property is located.
Fding Dates: 1) Real Property. Must file durirg Ne year Por which the deducfion is sought.
2J Mob�7e / Manufactured Hortres not assessed as Real P�operty: Must file dunng the twelve (12) months
before March 31 of each year the deduclion is sotyht.
See reverse side f9r.�dditional insfructions and quali�cations.
MP�^� (o�ttceror buy�' see re5ri�m rev�e side1 _ y,
GIBSON COUNTY
1 File
n,n m w;m:
N V 2992�h ^��°�
' Counry RecoNer
C.
Tapng DistrirS I' ^}°�_ � ��� _� VO ' y� Q�` � 1 g l.li{O Rem�d nurypef Page numbel
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Assessed vWUe of real {aopixry az ot Mort9age / Contracl "udehtedness unPab az of Mwtpage / Convaci trMnnron,KK� unGaid as d Is Ne aPP��t Ne sole
MaM 7. arrertt ym 1, nt year ]� date of aPP�� legal or eWtqhle v.meR
SDV ❑ Yes ❑ No
n �a, what � nis / ner eraa share or interest? ' u avn,m wF.n someone omer mar, sv�. uwkate wim w�wm
tt'ume on remN b NTrlent Uun Ihat ot a7P��t h�dinte heiwr. Is Ihe P�GP+b � Vuesfion: MnuaOyASSessed
❑ Real Property Q Mnuaily AssesSed ...
Name of rtnrtpagee b conU2a seller
Address af mwtgagce a contrap seller (number and strea4 �ily,
Name of assignee w other owner w hdder of rtprtgage
Add`ess o/ assignea (numDeraM street dry, s+ate, aM ZIP pod
oxn pmperty in any other
�� ❑ Yes
p¢Euction appraved'ui ihe artrount al:
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(�,Ey �am�.s �.
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�a-5aiy
sted on P�Y
Yes ❑ I
20 _ 20 _ 20 _ 20 _ 20 _
nawre d CoimN Audrtw Caunry �ate inpnth. daY. learj
I I We cerbfy under the penalry ot perjury Ihat ihe above arW foregoing irtfortnation is W e end cortect arM that the applirant is a resident of Ind�ana aM
own�Pl mntrad buyer of ihe aforementioned property on date appiira0on is filed.
� _ �F �Pwnefs fu0 narr�al . . . .-� ,. � Date (I�mC� daY• 1='a�
Peison
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1��
Q
Grlson (numberantl sbeet �: sfafe. antl LPmtle) . I �