Mortgage_Scherer (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_. • FOR DEDUCTION FROM ASSESSED VALUA�� ��
� State Fwm 43709 (R71 / 6-09)
L,µ i p��hed G1' �ePartmeN W Loral Govemment Friarze
File Mark
INSTRUCTIONS' � � ��
To 6e filed in erson of 6 ma�l wifh ihe Coun AWifof or Coun Remder of Ne cou efe e Fortn med with:
a Y iv b rtY is located.
Fdiig Da[es: 1 j Real Pmperty: Must file dunrg the year (or which the deduction is soug hE ,ounry Auditor
2) Mo6de /Manufadured Hwnes rrot assessed es Real Property: Mus1 /Ne d++rf�12) months ❑
6etore March 31 of each year the deduUion is saght. Counry Recorder
Seerey4r�esideforadditionalinstructbnsandqualifications. � GIBSONCOUNTYAUDITOR
(�p owriej or contra se� resLCGOre an reverse srcle) n _ . _ 1 �
CT � r�r�
ro.
name on record'a d�llerent Nan Nat of app5canc, uMicate Eebvr.
Name of rtnrtga9ee or a
Address of mortgagee w
mortgaga
F=3
o( asagnee (num0u arM stree4 uh. s+ate, and LP cade)
���
�oC10"� �
rc �,ea �m mm��e
6 Ne app6rant the sde
legal or eqWtabie ame(/
❑ Yes ❑ No
spouse.'udkate Wth whom
Is Cm property in QuesGOn: MnuaOy Assessed
❑ Real Properly ❑ Pfttlua�h/ PSSessed
I Ooes ePPlirent wm praperry in any oNer I If yes, what munt�/1 I VJhal Ta�d`q7 D'avict? I Has Na tledufYian Eeen requested m p`opeM1y I
counry m indiana? n Nn for artent Yra(?
n Vx ❑ Yes ❑ No