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"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
, FOR DEDUCTION FROM ASSESSED VALUATION
• State Fotm 43709 (R71 / 609)
�' PresvibeG Dy Oeparlrtrent ol Loml Gavemment Flnarrce
INSTRUCT70NS:
To be fited in person w by mail with the CountyAWitor or Counry Recorder of the counry whe2 the p`operty is bcated. M
Filirg Dates: 1) Real Pmperty Must file dufi�g the year /or which the deduction is sought.
2) Mobde /ManulaUUmd Homes rat assessed as Real PropeRy Must file dunng the tweNe (72) months
befae March 310/ each year the deduction is sought. C�
See reverse side for addiGOnal instructions arM qualifications. �
what k tris 1 trer exart shara of intrJest?
11 fartie m recaE is ddfe�ent Uan Nat
Name W rtqrtgagee n wntraa
Year
O �Z�QdunryAUditor
�,-�— Counry Recorder
n0u I legal desoiption Recofd nu Pag@ num6er
Mort q-a/ - a-o -000, D 3 S-O o 7 O�� ic:3
Marrh i, a�rrentraa intlebted�ress unPaiO az af �MOrtgage ��� udehtedness unPaid az ot � a7D�'�de ovrtmY!
Oi�V ❑Yes ❑ No
rc owned with someone oNer ttan evo�. Ind"wte with whom
ani. InCUate 6elow Is ihe Proprliy in Ouestion: AnnueVy AssesscW
�Real FoP�KY ❑ �Y � _
— GMAL
nq�igzge� or mnbacl seder (num6cr and saeef, cdy. sbte. ard LP cade)
or arer owner or naaer o� morcgage
of assign� (numOer antl stree4
Dces epplitaN ovm P�PQnY in any aher
couiLLyminEa`a? I-'I .,'_
/3
��
llra�ver NO.s�Q��.....
ca,�a ���o. lo3y
..........}. ........
��i�0�
nasmsaeuw..�wo....,�._..,.,,._.,.._�_., I
����� ❑ Yes ❑ No