HomeMy WebLinkAboutMortgage_Douglas (5)"'3 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_. % FOR DEDUCTION FROM ASSESSED VALUATION
. • State Form 43709 (R71 / 6-09)
�' y,. � Presrnbed by OepartmeM of Lofal GovemmeM Finence
INSTRUCTIONS:
To be filed in person or by mail wrth the CounryAUditor or Counry Recorder o/ the county whe�e [he pioperty is located.
Fi7ing Dates: 1) Real Property: Must file dunrg the year (or which the deduction is sought. �
2) Mo6�7e / Manufactured Homes rrot assessed es Real Property. Must file during the hvelve (12) monG�isE �
be(ore March 31 of each year the dedudion is soeght.
G`�.
See reverse side (or additional insfrucGons and qualifications.
x � �gal desaipUOn
_ i1,07 —
�a � �r� wo��
A/aIN 1. aarent year
I( m. Wut k!uc I Av ov�n oAam N ienune�]—.
�� � �C�.c�'"
��`w v
�'v vvi \ �
_ �acJ .
��,��� �U��
� �o -�
, �
s
�c �Q �o� �o'`(
� �� � �G
---�0 [,l � I�.A S �l ; -�
, I ' 1 WiJf
ia-����
Fortn filed with:
1 (1LIZCOUntyAud'ROt
❑ Counry Recorder
GIBSON COUNTY
_ 003. y 5 / -o �- '0/
iPaid az ot Mongage / Contracs intlebtedness un0aid as d Is the aOPlkant Ne sole
tlate of appOCation h kgy w equitahle rnmeYl
CJ D D D ❑ Yes ❑ No
tt owned wiN sortieone attwl man rouse. indxxte wlih whom
f, aM LP cade)
. �.s a c.
auntyl 4Mai Tadtg D'atrict?
COUNTYAUDROR
20 20
Caunry
�Isthe ropeltyinquestion:MnuallyASarssed
���� o��
nk,naP � nc s
20
Date (monfh, daY• Ypa�
� P�nY
❑ No
20
id foregoing infortnation is W e and corteU arM that Ne applirant is a resident of Ind�ana and
date aPP�ication is filed.
� ��,
�
��,�.�y
�