HomeMy WebLinkAboutMortgage_Sandusky^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
• FOR DEDUCTION FROM ASSESSED VALUATION
� srne wrm aa�os �n i �os>
�` � pr¢sa�bed by �epartmenl of Lacal Govemment Fnaxe
INSTRUCTIONS: -
To 6e fiied in person a by mail wifh the CounlyAUdito� or Counry Recorder of fhe county where the pioperty is located.
Fding Dates: 7J Real Property: Must file dunng the yea� for which the deduclion is soughL
2J Mo6Ae / Manufactured Homes not assessed es Real PropeRy Must fiie dunng the hvefve (12J montlis
befo�e March 31 of each year the deduction is sought.
See reverse side /or adtlitional insfructions and qualificatlons.
Tarirg District
Iq. vuhai
name on
��
d real pfaperty as d Mory
Y� �
I h¢! ¢X2CI ShNB Oi NfBRSi?
U is dMe+ent Wn Nat of aooGWnL rtMi
Name o( mortgagea w contraG 5eller
Address of martga9ee ar mntrad se0er (numbe� a
Name ot assicyiee or athei owner w hddu of trorh
naar�s ar as�v� t�� �c so-eec c�: •�°•;
Oces epvlimnt am P�PeRY in any oU«
counry m Indana7 ❑ Y�
❑ No
DPducUOn apprrned'ui itre amount o`
��
rdstreet, ciN.
ZIP rode)
Gqy�ipy�mr
County Recorder
GIBSON COUNTY
Mortgage! Contract indebtedness unpaid as d Is Ne applkant the sole
date of aPPOm� Iegal or equibGa owneR
❑ Yes ❑ No
wiN someona other Nan spouse. indicate wlth wfwm
� i �,�. Is Ihe Praperty in Ouesom: MnuaM Assessed
' � Real P(oPertY � %vmually Asessed . . _
� QuSil,� DA�t� �
�uNN� m
� � '02 (c (i�
:ted at pfopelly
Yes ❑ Na
20 _ 20 _ 20 _ 20 _ 20 _ 20 _ 20 _
Sig�aWre of Coimb Auditw Counry Date irtmnfh, daY YEa�
I/ We certify under ihe penatty of perjury that the above and foregoing intortnation is W e and cortect arW tha[ Ne appliranl is a resident of Indiana and
own�7�ntract buyer of the aforementioned property on d�te application is filed.
(o hA imme) a � Date (rtnntlt. daY• l'ge/)
Person aufho�ae0 Oy Ouly executeC Power of Attm�ey or Cy I(�1.7-72-0.7
Pdd25s of aNhor'¢ed person (numberarM strae4 �: sbte, enO LP code)
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