HomeMy WebLinkAboutMortgage_Zerr STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDaIESAA lOttounty Township Year
`; i, FOR DEDUCTION FROM ASSESSED VA� TIOtl;RED rooster _
.• State Form 93709(Rh /6-09) t'
acceptance for
Prescribed by Department of Local Government Finance Subject to final accept ,
day D{ �r. ) `, j tt File Mark
INSTRUCTIONS: �- k I r
lb be filed in person or by mail with the County Auditor or County Recorder•f the cou r P. : 1 e prope,r is rg F LL..N__�,,,,with:
Filing Dates: 1) Real Properly:Must file during the year for which the dedY•'on i_:µ...... G7•son��t tt11tl�C Imo/ County Auditor
2) Mobile/Manufactured Homes not assessed as Real P••‘II'! �!."te•uring th¢t�v 12)ra i }��J, dun Recorder
Auditor
before March 31 of each year the deductions sought County
See reverse side for additional instructions and qualifications. Parcel k
1' wi t owners buyer- resn+v:,es on re rse side)
• ' � l�xt>b,q 3L GIBSON COUNTY AUDITOR
# numnp la r regal desaiption Record nun Page number
Assessed vakie of real OreSzt Z6,.-oy zy_1.211
O l ab(3o 9a-a aol. MEI.,
March 1L aeren year property as of Mortgage• ntry�indehted s unpaid as of Mortgage fpf � indebtedness unpaid as of legal imitable owner?
c31 000 ❑ Yes ❑ No
If no,what's his I her exact share of interest? If awned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
Weal Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee pin T 9
Address of mortgagee wrcontract seller(number and street,oily,state,and ZIP code)
Name of assignee or other owner or hxdMr of mortoace
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�
Address of assignee(number and meet airy,scat ,\` .A-S\-f\---
Does applicant own property in any other [_ysj\
county in Indiana? Q Ff -1` —
❑ Yes ❑ Ni U - 'o
\1 __. ii. cb
Deduction approved"n the amount of � I.
\0. — `O —
20 20 I
3c.r.)\ \_ ? 0D-0 `� —.
Signature of County Auditor 0)._ � ,4 5C,SU '-' \� .5✓i`�_1�
I/We certify under the penalty of perjury t g_rJ"'-+"-'-- -- C\J " v`!s--1TL
owner/contract buyer of the aforemention \ _
7.gfaddressMa2nt wneels fug nme)F e (number and atrer
04 tr 203 'a,/-vlca it.../ Y7(j6
Person authorized by duly executed Power of Aitomey or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city state,and ZIP code) •