HomeMy WebLinkAboutMortgage_Bailey^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun o n p
__„ � FOR DEDUCTION FROM ASSESSED VALUATION
:• Sfale Fortn 43709 (R11 / 6-09)
�` PresaiGetl by DepartmeM of Loral Govemment Flnaxe
w.
�srRUCnoNS:
F''T��'`2 2011
Fwm Ned whh:
be filed in person w by mail with the CountyAWitw or Counry Recorder o( the counry where the property is located.
Filirg Dates: 7) Real Property: Musf !le dunrg Ne year (or which Ihe deduction is so�rtjhf. ��Coun d'
2J Mo6de / Manufactuled Homes not assessed as Real PropeAy Must Ae dunng Me twelve (72) months [� CV�n
before March 37 ofeach yearthe deduction is mught IBSC7fl CVUN�Y AUDITOR
See reverse side for add7tional insvucUons a� qualifications.
App&arit owrie�qrcmtrdrl6uye�-seeresLkL'ons revegesid� '
1
Tap�g istr� Key ber I legal desmiption Remd mimber Page numberC�
' —��l^ �� '��� �� ��� L
AseseO vdlue d real VoO�Y as d Mort9a8e / Cantracl indebtedrress unP� as d Mortgaqe / Contraa udebtedness un7� as of b C�e aDW�t the sde
�1. aa`mt year Mamli 7. a�rent yeer data o( appfzation kgal a,Weau imble ovnrY.+
.� i`j j�iJ� C7 Yes ❑ No
It no, what a his / her e� sliare o! interest?
If name on remrd is tliRerent Nan
ar mntrxt se0er
mortgagce w mntraa se0er (n�mbv and snael, ciry. sbte. ard LP code)
Name of assignee or othrl owner rn twlder of rtqrtgage
xA�mn
pfopenY m 0�: ArunieDy AssesseE
'-al Pmp�tY ❑ Annual�Y 0.s�sed
D ��� „��,- .� o...aDO3. :
ACC2ss of "` �nee (number aM stree4 �}: sbte. antl ZIP mCe) � 1 I' U j�' O ' O I
. .....;.$.y/...
Dces applinM awn property in any oNer IF yes, what counyt Whal TaArg Dis �� 5� � �
munry m Ind'gna? �
❑ Yes �o _ I _