HomeMy WebLinkAboutMortgage_Weyer STATEMENT OF MORTGAGE OR
CON County Ty Tow nshi p
Year
S FOR DEDUCTION FROM ASSESSED VAO
f"_ State Form 43709(R71/6-09)
.,
Prescribed by Department of Local Government Finance
INSTRUCTIONS: JUL 3 2013 File Mark
To be filed in person or mad with the County Auditor or County Recorder of the county where the m Form filed with:
Pe by b N N property is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction' ought. W Coun ry Auditor
2)Mobile/Manufactured Homes not assessed as Real Property 1 twelve(12)months
before March 31 of each year the deduction is sought County Recorder
GIBSON COUNTY AUDITOR
See reverse side for adds'.nal instructions and qualifications. (,/("�{�'///�/'
Appfcant(owner or•. hart b.w-.-sea re avers e) - r r -Y /
d' !(• `, . ' Key tier/legega11L dcwiption Recd num Page num
—r8-3�, a -coca_ � Day of DI 3
valve of real property as of Mortgage/Contact indebtedness unpa f Mortgage/Contact indebtedness unpaid as of Is the appGrant the sole
Marsh 1,c neat year March 1,current yyar I� oN
date of application legal or ❑
If no,what is his/her exact share of interest? 1-.X1 If owned with someone other than spouse,indicate with whom
If __ _.__emu_:,,.;,-'t �,,,,,_ _ _ Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(1C 6-1.1-7)
Nan (9().-°(Y) .
Add (9 'code)
Nan an,y To ,
Add
Doc Case y`i • What Taxing District? Has this deduction been requested on property
cou (/J� for wrrent year?
❑ Yes ❑ No
51 3 C�, COUNTY AUDfTOR
Dec �
20 20 20 20
sip i County Date(month,day,year)
C•
I al I O / U 9 (X', )Ding information is true and correct and that the applicant is a resident of Indiana and
V plication is filed.
Date(month,day,year)
(xui ' I lU LI—1 CO3°(
Per Date(month,day,year)
Mr