HomeMy WebLinkAboutMortgage_Angle�
"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
�_ = FOR DEDUCTION FROM ASSESSED VALUATION
� . ,. • Sfate Fwm 43709IR71 / 6-09)
�' ,«. � P�esaibed M OeP��M al Loral GovemmerLL Fnanre
File Mark
INSTRUCTIONS: . �E F �
To 6e lled in person or by mail with the CountyAUditor or Counry Remrder of the counry wfrere the pe rs locat
Fi/ing Dates: iJ Real Pmperty: Musf (le dunng the yearlor which the deductlon is sought. � Counry Auditnr
2) Mo6ile / Manufactured Homes rrot assessed as Real Prnperty Must 51e dunng the��wnt s� I�,
befole March 37 of each year the deducfion is sought �,L7 �unty Recorder
See reverse side 70! addiWnal instrt�ctions and qualdications.
Mv��� (owner m mntrad Auyu - see reshirdorss qn re�erse sida)
wss�a � �r re� w�r � a
AfaN 1. nrrenc yrar
If ro. what is his / her ezar2 share
.:�
selkr
r/ legal drsaiption / � Remrtl num
-� � -o�. 300 - 000. 003 -oo ���
Mortgage / Cantrad indebtedness unpald az o( Mwigaga I Contrart mdebtedrress unpaid as af Is Ne
MarU 1, curtent year � tlate of appGCation kgai
Name at assignee or oNr! ovmer or halder ot rtart9age
MAmcc ef assionrs (number eid sheeL r4v. s1affi. an
ovm property in any oNer
ia? ❑ No
❑ Yes
ueauaon appmvea m me amoum ar.
�_ �����_
����
I/ We certfy under t¢'� penalty of perjury tha
owner I contracl bu�er of the aforementionec
��,��2" �// m4�
11 resident add�css o( appfrcmant (nuvlDe� antl sbee4
7s �i �',/ ��c E.
ciry, stste, arrd Z/P code)
k
Yes LJ No
sameone oNer Nan spouse,
Is the 7�PenY in 7uesGOn: MnuaQy Assessed
❑ Real PmPenY � ���!�Y �
� �
�
� . -
��
,
�- ,
. �_
�
fdtlress of aNhIX'vEd per".An (number aM sbeet. ciy, sfat¢, anC ZIP mtle) . I ,/
/Y