HomeMy WebLinkAboutMortgage_WhitakerSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ou 7o s ip vear �
__ _n = FOR DEDUCTION FROM ASSESSED VALUATION
� State FOIm 03709 IR71 / fi09) �
�' Presaibed M �epartmeM of Local GovemmeM Fuance �
� JUL �e ^^�1
wsrRUCnoNS:
F«m mea w�m:
To be filed in person w by mail wiN the CountyAuditor or Counry Recorder o/ the counry whe�e the pioperty is located.
Fil'mg Dates: i) Real Property: Must file dunrt�g Ne year /or whicA fhe detluclion is soughG " �y q�d���
2J Mo6de / Manufactumd Fbmes rat asseued as Real Property: Must file duriig the fweNe (72) months
befora Maich 37 ot each year the deduction is saghf. �
GIBSON O Y
See reverse side !or additio I in '� aM qualifications. l,
I nv�m (ownerm oww`act rcsax�bns m re.mm sife) �1,. � /i1
a l00-00/. /39-00
Assessed rah�e of real p�opeM1y as
M� 1. am�nl Stlr
m, vTat 5 ns! twf erad snare ot Interesr!
�ame m iemU b EiRerent Nan Ihat W aOW�C h�Oxsm Eebw.
Name M mM9� ar rmvaU se9er
naaRSS ot rtartga9ee or m,o-aa
Name of a4ignee or otTC awner
near�s
ty m anv
r"
I°°' `�'.
:
^�; c
��.
Is G^,J`O✓.
I I .tr Na
owr. .. �vaa buyer
7naWre (ownerY h�neme;
r, n ..
ffi�.
�Y.stan^. ��ya)
mat couny+
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i
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> ��'� 117
Is ihe app0�ant the sale
kqal a eQUftade ovme/1
❑ Yes ❑ No
somaure other Ihan sP�K. iMkate wiM xlmm
NTat Tadng District?
p
is C�e ProP�Y u� 7uestian: P+uwa�y Assessed
❑ rieal Propenv ❑ !4,rn;aM nssessed
OeauOm oeen �eGUestea m poperty
��' ❑�� ❑No
� �_
Date (morvn.yy, yee�
above arM foregoing infortnation is We and mrtect ark Nat Me applirant is a resident of IfWWiana aM
>erty on date application is filed.
Date (month. daY. Y��
(numDeranE sheet Wi: sfate, eM
I O 0 S S S�d� M
auNa¢W M' dM' ezttu:etl Prnxer
person (number antl sbeeL �: s7a(e. en0 LPmtle)
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