HomeMy WebLinkAboutMortgage_Ott"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
Stata Form C3709 (R71 / 6O9)
�' ,.r � RrsaiCed by DapaRrtieN ollaal Go�emmerrt Fifwice
Fi
INSTRUCTIONS: F� � �:
To be fded in person w by mad wifh Ure County Auditw or Counry Recorde� o� fhe county where the poperty is located. A� �(� � Q 2 Q � �
Filing Dates: 1) Real Property: Must h7e dunrg Ne }rear for which Ne detluclion is soughc �� Counry Auditor
2) Mo6Be /ManufaGUred Homes not essessed as Real Property: Must file dunng the tweNe (72) months ❑
befora March 31 o/each yearthe deduGion is swyht ���d�
See reverse side /or addifional instnxtions and qua/fications. �
��°^�f°�S°f�b�� M^f°�"��"a'�°� (� �:�f 1 �,f1_I_L GIBSON COU _
� . .� u u � � - �� � Y �[� �'\ � ( JTr
AsusseEra4ieUrealP�Y�ot -
Mamh 1, anml y�r
If ro, what is h¢ / her eraG share of intrRSt9
H nare m remtl a dAter�nt Nan Nal
rlame m �ee « m,aae
— vuv • .x
;ebtednass unpaid as W
Addiess of rtnrgagee ar mnbaG sWer (number and sCee4 mY• �. aM LP mde)
Name d assignee v atrer owner w hoker rn O� �' ��/+4�" ` V
AOCre�olassi.Fee(numbereMatreet�#1: ^�� /
Oces applimrLL awn property in any oNri �-" �� //
�,^p' �, i^e�aa n .,_ n
za_ I p— I p— I 20— I �
EteEr�cs w�v� as d I ls Ihe eOW�� ihe sale
legel or eQuitade awnelt
❑ Yes ❑ No
spouse. 6dkete witli whom
IS Cie propvly in 7uesoan: Mrnia9y Asses�eE
❑ � �xnY ❑ %�+�Y�
e�oa� r� nc s�.
Ecen reQUesLeO m prapnity
❑ Yes ❑ I
zo_ � zo_
Si9�ture of Counb AuObor \�11 � Counry Date (rtqNh. tlay, Yea�
� I/ we certify under Na penalry of perjury ihat the above and foregning intormation is we arM cortect arM ihat the applipnt is a residerrt of IMiara aM
awner 1 contrad buyer of the aforeme�oned pruperty on date applicalion is filed.
(o hN reme Date (rrwiCi, daY. Y�/)
�,1,.��'h�-
rnt�rs of appfrant (numGer antl strae4 � stale. and LP aotle
�57� �ISr Sf�/c �coad' G �� C/f,
P�on auNavetl yy dWy esewttE Powr1 W Avamay w M IC 61.1-12-0.7
1
lddress of aWwr'ved person (number enC sbeeL tdy. sbte. and ZIP cade)
�. �,:,�
_ J ��