HomeMy WebLinkAboutMortgage_Tepe^��a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ .= FOR DEDUCTION FROM ASSESSED VALUATION
• Stala Fortn 43709 (R11 / 6-09)
�' ,�,� ? PresaiEeG by Department ot Laral Gwemmerk Fnarce
a
�NSTRUCTIONS:
b 6e �led in person w by mail with the CounryAurlitor or Counry Recorder o/ the counry where the property is located. N O
Filirg Dates: i) Real Property: Must file dunig Ne year far which the deduction is souqht.
2J Mobde / Manufactured Homes not assessed as Real Pmperty: Musf file dunng fhe hveNe (72) months
before Ma�ch 37 of each year the deduction is sought. �p C��
See reverse side for additional ins7uctions arM qualificatinns. b( J. -,3 O 9- �OO �
qppfmary�(ownerormqtrac+buyer-seerewir�or;sg�re.e+sesitle) � '
Z'�unry Auditor
_ j'qunry Recorder
R
Tari Key mimDer / kga� desaiption / R numba Page wmE�
a - _ a9 �yoo -oo�. � � 8-00/ �
Assesed.aWe of ma1 WopertY as of A/or(qa9e / Contraa irdebteA�ress unPaid as d Mortgage / Conrad iMebteEness unpaia as d Is ihe eOP�+t ihe sde
MaU 1. amtvrt S� MamJ� 1, wrteM 1'�r date of appfiratm �gal or eWRade oxnM
� Q� ❑ Yes ❑ No
I/ no. what's his I her exaG share af interest? . If awned wiN sameo� oNer Ihan spaae. indkate with winm
If nartre m record is dAferent Nan Nat of aPP��4 ��te belwr. Is Me pmpeRy in question: MnuaOy Asessetl
❑ Real RoPeKY ❑ ��Y As��
Name of rrort�8a9� or �ntract seuer �
Pddren W rtnrtgagee w(oontraa se0rs (numbPi end stree; city, sta:e, ard ZIP code)
Name of assi�ee or othn owner w holder W morigage
Adtlress a�nce (nurtiber aM sfreeG cdy, slafe. and ZIP code)
�T �tJw SE sE a 9-3-�
Dces epplirerH oe+� yoperty in any oMa It yes. whal counq/.�
munryinlMetu? n .,__ rl .�_
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,�
I I We certify urWer the penal
owner I cantract buyer of Ne
T� �s�i C. r� u� aem,�, o�� Ra�a «� v�vPm
COUNTYAUDITOR Dra�vCC �i�... �.7.� x
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�_ Za— c�►�a ��o.�....47'�`�
,
Caunry
that Ne ve and foregoing intortnation is We and mrtea arW ihat ihe applicant is a resident of IrWiana aM
neG D rtY on date apd�� � filed.
a+d ZIP ootle)
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iWnr¢ed by dWy exewted Pawer af AttomeY a M IC G7.1-12-0.7 �, " I�� (��. �Y Y��
Mautha'vedD�sm (numbera�MSbee;dry.5bfe.andZlPoode) .