HomeMy WebLinkAboutMortgage_Besing"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T shi Y
__ , FOR DEDUCTION FROM ASSESSED VALUATION ,J
State Fortn 43709 (R71 / 6-09)
S f Presrnbed by Department ol Laml GovemmeN Fuance
INSTRUCTIONS:
� t�ed with:
To 6e Red in person or by maii wiN !he County Auditor or Counry Recorder of the county whela the property is locafed.
Filing Dates: 7J Real Pmperty: Must file during the yeallor which the deduc�ion is soughG J Co�nt�y`�inditor
2) Mo6ile / Manufacfumd Homes rwt assessed as Real Property Must fi/e dunng the twelve (72J monfhs
6efore MarCh 31 of each year Ihe deduclFon is sroughL G IB N�UIQTiNnt� @�@d3�d
Sae reverse side for addiuonal instrucLOns arM qualifications. ., .
Appfitant(ownerorcantradbuyer-see reversevde) n _
o�sma
ed vaWe d� propeJty as of
1. qaretY year
ir �o. �i x ms � n� e�c �,are o� �,��n
tt'wrie m remrC's drtuen� Nan Nat
�neay� a
�er I legal 'ptirn � a d� Record number Page numEr!
- _o -�oa-000.4�- 3 aod� as
Mamh 9, airtem ypar ebtedness un0aid as W dM �t9a9 P/�`� mEebteEn�s unPaid az of �I wPM���de ovmeYl
❑ Yes ❑ No
If owned wiih someofre other than spouse, iMMste with wtnm
m ma�re cemw m �Pmy � a�sm,: a,��y asse�.w
_ Real PmP�Y ❑ ��Y �
•..ti.'e w�ma fIC 61.1-�
L
p�,-r,�,�e p� S./� /n�NA�Zv- �?�/gy`/3e3.�G
Pddrea W rtqrtgagex ar mntrad s�er (number and streeG ray.
Name of assignee w other awnet or hdder of mortgage
(numDer entl shee4 mY, slefe.
any oNer I If yes, whal counf/.� I YMat Tadng vo.,.u.
d�-�OS/
���n ❑ Yes ❑ No
A