HomeMy WebLinkAboutMortgage_McCarthy°"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
� FOR DEDUCTION FROM ASSESSED VALUATION
State Farm 43709 (Ft10 /11-08j r
� � Presaibed DY �M�ent d Loral GwemmeM Firiance
INSTRUCTIONS: Fle Mark
roear,�ear��a,orny�a�;mu,aco„�ya�a��du,a�,�tywnarer�aaror�nr�s�o��an. JUN 3 0 2009
Fiirg Dales: 1) Reel Property.� Mutt h7e tluing fhe year lor which the deduttion is soughL
2) Mo6de / Manulechired Homes not assessed as Real Property: Must file dunng tlre hveNe (12) mmtAs be(ae Maich 37 0/ each year
tAe tleduction is saght �aµ ��
s�,��s;aa�.eda��;�wab�e,�aq�r,�eo,�s G � ._,...
I�T�
amipuon v
/ - o �-6oa..�� ao 7
� 7 Cantrad indeMeElrea w�ald as d MaNpapa / Cwm
axrem year dafe af appfimtion
tl ro. whal is his / har wmd share d i�resl?
C ruma m recad'a d�arerit ihan Ihal of aW�M. indimfa bebw.
Nama d mortgagae or conYad �/ `
�
O1
Pddress d mo�gagee «cmtraa seo (mmberantl strt:o( dty, state, antl ZIP codo)
Narna d assip�ree w o8ier wmer v hotlm d rtioRpape
neer�: m
H amed with someorre a�er Ihan spouse.
Does apptirant awn qopany In arry aher I G ye5, w161 COUt�ty"I I u
muMy in IMiare? ,
❑ Yes ❑ No -
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DeduclianaPCmved'mlM ^1Csl.f'S�"" 7 J—!J� �
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� O� l l �k 8 �
Signature d Cauerty Audita
fOR
Y
Reard number � Page
ss
Yes LJ No
�Is B WopertY in Ouetion: AmaaM Assessed
Real H'opeAy ❑ MnualyAssessed
Ibr wrreM YeaR � Yes
� �
Date (rtmN, tlay, yaar)
No
zo_
1/ We certify under thc �_....,� ..� yayry mat ihe above and foregoing uifartnation is We aM correct antl Ihat the ap�can[ is a resitlen� of IMia� aM
owner / can6acl buyer of I�e aforementioned property on date application is fiied.
�,nat n / � I 1 /I / I � / / 1 � �tiii ! //✓ � Date imorW�. EaY. Y�A
FuA
a
ffim,
AdEress d auttprized person (number and shoat, dty, sbfe. and LP codo)
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