HomeMy WebLinkAboutMortgage_Arms"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Yea
_,_ � FOR DEDUCTION FROM ASSESSED VALUATION
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�' I R�aibed ITJ DePM�N of Lnd GovemmeM Fuarce
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INSTRUCT70NS:
To be fi(ed in erson w 6 maT vrith the Co Auditw or Coun Recorder o/ the coun wFiere the ro Fam mad with:
P Y �+mY tY N P PeyY is bcated. �-y� l.�1
Fifing Dates: 1) Real Property: Must file dumg the year (or which the deduclion is sought. � N O 2 y�C DY�unry Auditor
2) Mobile /Manulactured Homes rrot assessed as Real Properly Must file during the hvelve (12) months
6elore March 31 o)each year the deduction is sought. C,� County Recwder
See reversa side tor aCditional instrucUons arrd qualih tions.
np • (ownrsrconuaftbvtms-see�sniUioruanreveru e)n GIBSONCOUNTYAUDITOR
Uagng�isVicl (/ KeyntenDer/le�alEesaiP� —�O� 'C7d/• / � ' Qa� V � Pagenu /
3 �.
Assessed reNe d real as of Mortpage! ContraU 4de6tedness unpaid as of Mortgage / Contrar3 indebtedness unpaiE as d 4s Ne appGnnt tha sole
MarU 1, aumnt yrar Mardi t wrtem yeer tlate of appGration Iegal ar equitable owneYl
❑ Yes ❑ No
11 no. what Is ttis / her e�2 share of interesi? IF owned with someone oiher spouse. iMicate wIN whom
::�
Name of
Md(ess of mort9agee w wntract uller (nwn6er end stree; cdy, state, aM LP cade)
Nama of assignee w other ovmer or holder af mwigage
Ad�Rss Of assignee (number ertd 5treeL d}; state, Bn0 LP tode)
Dces epplilant awn property in any othu If yes. what munty7
munry in IMana? ❑ Ye5
❑ No
DeCucuan eppmved in
20 _ � 20 _ � 20 _
Sigre7rta d Camb Audrtnr
e .7-. �
I/ we certiry undu Ne penatry ot
owner I mntrad buyer of Ne afor
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Nat the
couNn.
stion: PnnuaMASUUE
❑ !imli�al�Y A55eS�
Ge(�'�y•�� �9' C4rn yn Arrr��
�,J S tedonP�W�Y
D���,����� �o. .Ql�. ❑ No
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Card NO. :.,:.1:(Q�.........
�J �.�y� �
20 _ I lp � lM/� / 20 _
CouMY Date (rrmlh. daY. l��
,
rM foregning infortnalion is W e and mrtect arM Ihat the appiirant is a resident of Indiana aM
date appliration is filed.
Date (month, day, yea�
state, entl LP catle) ��
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�, � �v
�y 1�+,,
AddreSS of autha"¢ed prJSOn (numbe�aritl s0ee; ciry, state, an0 LP cotle) . ✓