HomeMy WebLinkAboutMortgage_Krieg (3)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
:• Slata Fortn 43709 (R71 / 6-09)
,.,� 1 PresaibeG Gy �eP��rtl of luwl Govemrtrerd Firerce
File Mark
�STRUCTfONS: .�gjy� ��j,�,y�
� (.� � JLJ � Fortn Ae0
To be filed in person w by mail wiN the CounryAutlitor or County Recorder o/ fhe co re e p i oca
Filirg Dates: 1� Real Property: Must file durirg the year fw whirh Ihe deduclion is h County Auditor
2) MobBe / Manulactured Homes rqt assessed as Real Property: Must Ae dunng fhe fweHe (12J rtanths � �nty Remder
ner�Ma�ns�o�e�n��meaea�a�nc DEC 19 2011
See reverse side !or additbnal inshuctbns and qualificatnons.
le9al d� V/ T l O ^/ 1.0�'—W�"T�P����(i�W / I P�e nl a/ /`�
Assessed raqie af real poperty as of Mortgage / Contract 4de6tedn�s unpaid as W Mongage I Contrar3 i�Mebtedness unpaid as d Is Ne appGr�t the mle
MarM 7, arren[ Year March 1. a�rtent year /�,�'�j'� Cate of eGP��^ legal w eWita6le ow'ce(.�
l liIJLJ ❑ Yes ❑ No
Ir ro. what fs Itis / Icer e�raG share or interest? It o«red wiM someme olher tlan sPp+se. inC'xate witl� wMm
Is iM P�Gert1' in VuesUan: MnuaDY Pssessetl
❑ Real Prope`ty � Armually AssesSed
« mnVaG seller
Pddress of rtnrtqagce m m�trac� seder (numDer end shee; cilY 9ate,
Name ol assignee w otha oxner or holder of rtprtgage
A4Cress ot assignce (numDer arW sheet dry, slate, anC
I Dces a(WlicaM o.m pmperty in any other I If yrs. what munp? I W�at Tadrg DisIriG4 I Has ihis OeCUCtim Eeen requested m proprlty I
������g�� n Yes ❑ No forwrrentyeaR
❑ Yes ❑ No