HomeMy WebLinkAboutMortgage_Coleman (3)'°'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN un 7 ship Year
FOR DEDUCTION FROM ASSESSED VALUATION �
Stafe Fwm G3709 (R71 / 6-09) .
S aresvited ny ocpartmarn o( LLow corenunent Frence
� N�V 1$ 20 ile Mark
INSTRUCTIONS:
To 6e ned in Form Aed wnh:
person a by mail wdh the CountyAUditw or Counry Recorder o� the wunry wheie the pioperty is located.
Filing Dates: 1) Real Pmperty: Musf file dunig Ne year lor whirh Ihe detluction is soughG � � County Auditor
2) Mo6Be / Manulactuled Homes not assessed as Real Pmperty Must file dunng the fweNe (1�n�nlp'� i� R
6eloreMarch37ofeachyearthedeductionissought G�gSOVCOUNTY UD�R�nryRecarder
See 2verse sida /or addifional insfnictions arM qualifications.
Deductirn aPW� in tice amount ot
20 2p _ 20 _ 20 _ 20 _ .
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I I We cer�fy uMer e penalty of perjury th e above and toregoing infwmalion is true and m ���� ..,,,,
� ovmer 1 mntract buyer oi the ataementiwi property on date application is filed. C 71-�] \ O. ... V
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