HomeMy WebLinkAboutMortgage_Kruse (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ip r
:._—..
: FOR DEDUCTION FROM ASSESSED VALUATION
� State Fwm 43709 (Rt t/ 6-09)
�' l PresuiOeE by Departmen� of Lncal Gm�emment Frence
�� Fi rk
�STRUCTIONS:
To be filed in person w by mail wiN Ure CounryAUditor or Counry Recortier o/ Ne counry where the pioperty is bcated. F� ���
Filing Dates: 1) Real Properry: Must fde durirg the year7w which the deduclion is sought �j�`�
2) Mo6de / Manufactuled Homes not assessed as Real Properly Mus( file during the fwelve (12) months �� \�
before March 37 of each year the deduction is sought. ❑ Counyit er
See reverse side for additional instruclions aM qualifications.
App&a rorcuntraC6uy�-5eeresMrL'on,sonreversesde)
Ta is ' Key rcmber / legal desaiption
.1-(.� - - S' �QO -(
Assesse0 vaWe oF real poperry az N Mortgage / Contraa'vdebtedness i
Ma�di 1, anent year Mard� t. n�rtent year
If rw, wha� Is his / Mr e� shara of interest?
If name on remC ig diRUent Nan Nat af appGran; i�Winte bebw:
Name of rtwngagee ar mntraG setler o
Address W rtnrtgagee or mntrad se0er (numbr� and stree; r1y, a�. ard LP code)
t
Name o( assignee w otlw owner w twNer d morcoace
- l��ClC.�i'� ` ° ' �
TA�E A PILL N �;�'� -
,_1 �,�t�, �
1 , _, � t� �
UN
( C1Y fll �l�.� d C� � I I
;� � 7Le�U Y�I.jL`�'.��.' � �
1 I
�v�1r u ri� �
��i ooc�os�r�
}/�� �`,7,�,` � �I p�
❑ IMMEDIATELY��O OIC Y BEHAlF` o i
�- ��-� L_. 4
Pdtlress of auttiiwaeE per..on (number arM sneet dty. sbte, aM LP�
i111.9
/� ^ D O / RecoN numbv Pa9e number
L� p � �_ � �o�--
Mortgage / Contra� in0ebtedness unpai0 as o( Is Me eOP���t the sole
date of appGntianT,7� legal w cquitahle oxnM
pJ (J ❑ Yes ❑ No
wiM someone oNer ihan spouse, i�iqte wiM whom
Is Me propeny in O�eSUm: W+nueM ASSessed
Rea� Proaertr ❑ o.mu,a�y Assessed
MoWle F�brtie fIC 61.1-�
4Mat Ta�drg Dislnct?
20
�?��
Has Ihis deduGion Oeen requesteO on p�operty
for artent ynaY.� �.. �.
20
oa�e (�w�m,. eay. r��l
�
in(ortnation is true and mrtea arM ttia[ ihe applitant is a resident o( trdiana aM
ion is filed.
Date (monfh, day,