HomeMy WebLinkAboutMortgage_Taylor (7) ', _ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
'° : FOR DEDUCTION FROM ASSESSED VALUATION
•-_-ei..4� State Form 43709(R11/6-09)
Prescribed by Department of Loral Government Finance
II-�!�r
INSTRUCTIONS:
Ib be filed in person or mail with the Court Auditor or County Recoder of the county where the property Form
Pe by County ry ty P Pent is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought 2 0 20 n County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)1Mridls Lr` I
before March 31 of each year the deduction is sought County Recorder
See reverse side for additional instructions and qualifications.
Appoca s(owner or contract buyer- e restrictions an reverse side) 1
CY F�J t..1 __ GIBSON COUNTY AUDITOR
T iseic( Key number/legal description /J rJ Record number Page number
rle • / A -p (, - WOO _ 003 _ 95, -oa- 51 13 /o Y9/
value of real progeny as of Mortgage/Cont2d'udebtedness unpaid as of Mortgage/Contrad'uMebtedness unpaid as of Is the app the sole
Mann 1,current year March 1 wrtent year date of apPtrcation legal w equitable owner.+
131, 000 ❑ Yes 0 N
if no,what Is his/her exact share of interest? If owned with someone other than spouse-indicate with whom
If name on record is different than that of applicant,indicate bebvn Is the property in question:Annually Assessed
❑Real Property ❑AnnualN Assessed
Mobile Horne QC 6-1.1-7)
Name of mango w
Address of mortgagee or contras seller(number and et,dry.state.and ZIP code) /�_
Name of assignee or other owner or holder of mortgage ) ,,/ f 1r(\ �'7 Z-7-j , -
C�/r / / C-(/G
Add of assignee(number and street city state.and ZIP e) ^ ` /4? Act-s(74- C
Does applicant own property in ny other If yes,what county? • What Tardn
county in Indiana? ❑ Yes ❑ No
1061.C s pieGO C iN4
COUNTY AUDITOF _
Deduction approved in the amount of it/3 I t�/o U LE C
—
20 20 20 20
Sig
gof County AUditw •� County —
I/We certify under the penalty of perjury that the above and foregoing information it d
owner I contract buyer of the aforementioned property on date application is filed. _
(ow
Full resident of applicant(nu and abe te,and LP _--�_
1S t k(.% ..ryjk c urea s !V "17 o7
Person authored by duly executed of Attorney or by IC 6-1.1-12-0.7 Date(month,day,Year)
Address of authorized person (number and sboo4 city,state.and ZIP code) .