HomeMy WebLinkAboutMortgage_Harris^'nv STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
� FOR DEDUCTION FROM ASSESSED VALU�� ��
Stata Fwm <3709 (R71 / 6-09)
,� Presm'betl q' DeP�N of Local Goremment Firarce
File Mark
lNSTRUCTIONS: n (�'�
To be filed in erson a b mad with the Coun AWito� or Coun RecoNer o! the co�hE4e th��rb�e Form mea th:
P Y b N rtY is bcated.
Fi7irg Dates: 1) Real Pmperty. Must file during the year for which the deducGon is soughL Counry Aud'Mr
2J Mo6i/e / Manufactured Homes not assessed as Real Property: Must duAng e N rrwnths
be/ore March 31 of each year the deducfion is sougM. - County Reoorder
Seereverse de additiona�instructions qualifiqations. GIBSON COUNTY AUDITOR
�ofrant(o ar hwel-see sidv _ _ �
I( no. what is his / her e�md sha
If name on retud is 6ftrlent IR
Nartre ot rtmrtgagee w contracl
naar� a ��ee «mwE
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Nat d aCP��L trdifate Eebw
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nee or owel owner u ha4+--
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AUDROR
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Counry
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as d Is Ihe eppll�ant ihe sole
legal or equitade wrt�eR
❑ Yes ❑ No
wRh wfrom
15 Ne ProPertY in QueStion: AnnuB�YAsscsN
�RealProPenY ❑!!�!�.Y�`�,._�_
sted m P��Y
Yes ❑ No
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Date (manM.
cert'rfy urWer Ne penatty of perjury that Ne above aM foregoing infomiation is true and cortec[ arM that the applinnt is a resident of Indiana ard
I contract buyer of the aforementioned property on date applicabon is filed.
(ovmefs !W nam� � Date (mrnth. daY. Yaa�)
T��
auUroraed Ey dWy exew:e0 Power o(Attcrney w by IC Gt.7-12-0.7
Maress of auNOraM persm (numDer arM sbee; aly, sta(e,
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