HomeMy WebLinkAboutMortgage_Mayer^'n STATEMENT OF MORTGAGE OR CONTi2ACT INDEBTEDNESS Coun 7ownship Year
• FOR DEDUCTION FROM ASSESSED VALUATION
. r— " sace r� aa�os �n i sas� `�p-�-�
•S ,,,. 1 aresmtee M cea�� ot Laai coremm�nt Frence @� ��� File Mark
1 . �L�
TRUCTIONS: F� �� �:
To be filed in person w by mail with the CowryAudito� or Counry Recorde� of the counry wheie{h ropry1y u located.
Filirg Dates: 1) Real Property. Must fJe durirg the year Por which the deduction is souglit: ��• 1�.��'! I C �Counry Auditor
2) Mobde /Manufaclured Homes not assessed es Real Pmperty: Must h7e during the tvrelve (12) months Counry Recorder
before March 31 of each year fhe deduction is sought. - C.'J. � �
See reverse side for addtional insNxtions and qualifications.
qpp�rt�ingiw�coqtr�t6uyer� arest+iqio�nsmrever�s+fe�^^n , I GIBSON COUNTY AUDITOR
%� Q �l� Y- �% ��L/ � � � ""7�^_
A�ed vahie of real P�Y as W
Mair1� i, a+rerR ymr
tt no. what Ls ha / her euG
If name on
Name of rtnrtgagee or mntrxt seAer
Addfess of mort9a9ee a cantratl se
Name of assi9nee w other awner or
�-�9-�a 30
of aDP��t ��mte below. -
mortga9e
coEe)
qm property in anY oNer I If yes. what munt�?
a� ❑ Yes ❑ NO
4� Ne artrount of:
20 _
I/ We certify under ihe
ownerlcontraclbuyer
Prl�n authwaeO
20 _
of perjury
unpaid as of Mongage / Contrar3 udehtedness unpaid as d
Eate of app&ation
tt awnM wi� someone ottwl than spoiae.
rira6le a�mel7
Yes ❑ No
Is ihe propefty in questlon: Mnually Assesud
❑ Reai ProPertY ❑ Mob ile �
Has Ihia deductan been reGUested m P�PP+�Y
rw�,emv�± r� .,__ n
D���,`.�,- vo. a�!..�.....
20 20 _ �C,/� �`'
Card \'O. ....`.{Jl.}1.�......
C°"^y r
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,the above and foregoing infortnation is true and cortect arW �hat Ne a��..,... _._
Droperty on date application is filed.
Da1e (montA. daY. Yaa�
7e�son (numGCr arM strae4 �Y• ��. eiM LP cade)
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