HomeMy WebLinkAboutMortgage_Perkins"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
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: FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate Form 49709 (R71 / 6-09)
' I Presa�bed M �epartmer�t o1 Lacal Govemment Frwxe -
INS7RUCTIONS:
To be filed in person w by mail wifh the CounryAUditor or Counry Reco�der of the counry where the property is locafed.
A7mg Dates: 7) Real Property Must fi7e durirg the year for which the deductlon is sought.
2J Mobde /Manufactured Homes rrot assessed as Real Pioperty Must Re during the nreNe (72) months
before March 31 01 each year the deduction is sought. �
See 2ve�side /or additional insfructions and quali�cations.
npp�rant rwcontraabuyer-seeresuicDmns re siq�) _ � .
• �ii'� l�if— ..d��.d —
nssessea rdnre a ma� poperty as m
Marrh t, axmrt year
Ii rw, what Is his / her exarl share o1 interrst?
Ii nartie m remd is 63emnt Nan ihat of app6ran� uMuate below.
�,,T,
oi marlgageP w mntraa seller
Name ot assignea w other mmer a halder of mortgage
AdCress of asvgnce
ooes eva�m�� �+„
dry; state, entl LP wde)
If yes. what count�7
Year
nCe�tfYnAUditor
1 LUIZ
County Recarder
' GIBSON COUNTY AUDITOR
1' • G� �_ V�� RecoN num6ri Pa �
l
a of MMqage / Corttract indebtedness unpaid as d b I�e eppfrarct the sale
data of aPP�� legal ar equita6le o.meR
❑ Yes ❑ No
wmed with someofre other tnan sPOUSe. kMicate wtth whom
is Na P�C�Y in Ouesoon: Mnua➢Y Assessed
� Real P(operty � Afmually As�
�a� r� nc �
P�KL?�s, n� �-�,2.ko� �
/ ", /`��� L
i /-59/3
4Vhat Tarin
b
I No
couNrr auorroa
DraucEOn appmved'u� tlie artrount of.
20 _ 20 _ 20 20 _ 20 _ 20 20 _
SigfaIIUe U CoimtY Audrtor County Date (monM. daY.1'�a�
I I We rtfy under ihe penalry of perjury that Ne above and foregoing infortnation is We and wrtec[ arW ihat the applinnt is a resident of Indiana aM
contracl buyer of the aforeme ' pro rty on date application is filed.
`„6� (o�meYS h� narsre) Date (monih. daY l�a+)
W a t um r an sbeel, aTy, atate," Z1P )
authometl �y d exewted Power o(Atmmey or by IC G7.1-12-0.7 Date (monN, dey, yea�
Pddress of aWm¢ed pelson (numDerarM sbeet, tiry, state, antl LP code) .
l'1