HomeMy WebLinkAboutMortgage_Deutsch"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
_, � FOR DEDUCTION FROM ASSESSED VALUATION�/�� J
� � Stata Fortn 03709 (R71 / 6-09)
� uu � Preunbed by Departmerrt of Loral GovemmeM Frence
\h' File Mark
INSTRUCTIONS: �U
To be filed in person w 6y mai/ wifh the CountyAuditor or Counry Recorder of the counry where the pioperty is located. F� ���
Fi!'mg Dates: 1) Real Property: Must fde durng the year (or which Ne deduction is soughG � Counry Auditnr
2J Mo6�7e /ManufacNred Homes rat assessed as Real Property: Must file dunng the fweNe (12) months
before March 37 0/ each ysar the deduction is sought. ❑ County Remrder
See reverse side lof addifionel insWCtlons arM qualfications.
g Distr'rY � Kcy rcimEel / legal dgaiption Remrd number
� ,�(� -J3 -�5�-�00-000. 1 � 3_00� ao
Mvessed ralue d real p�rqerty at ot Mor[gage/ Cantrati IndebteEr�ss unPaid as W Mortgaga / Con�aa i`Me6tednes5 unOaN as o( I
MaM 1. a�ft ymr Mafth 1. artent Y� , �. �. date o( appfration I
ro.
nartia m
with someo� dher ihan
Plameofmor�gea«m,o-aaseae� :/��f/✓/— 4� r
Address W rtnrt9agee or mntraa seder (numhrl end street, cdy, sfa . and LP oode)
Name ol �si�ee w mMr armer or MWer of rtqrtgage
ACCress ot ' (number arid saeet uN. s+etfi en0 LP pode)
w N`'" y- - 9 1 f} G
Dces epplifant ovm property in anY oMu It yes. what couM/t WAat Ta�drg DistriH?
�,uy �� i�a�a
❑ Yes ❑ No
DeducCOn apywad'u� Cce annunt oE
20 _ � 20 _ � 20
��� �
20
�I/ We certify un r the penalry of perjury th�(the above and foregoing infortnatlon is true :
owner I mntra buyer oF the afwementioned property on date appliqGon is fiied.
� 5igfumra (oxnefs h�lame)
FWI resideM ae0ress W aPP��t (numDerand sbee4 �'nl: srare.
w Ey IC G7.142-0]
per..wi (num0cr aiM sbeet �+ry. slafe,
Page wmGu
ritade owne(t
Yes n No
❑ nm��ya�e�
r�ae ria„e nc ��.
Has Ihc deduCim 6een re9u�ted m P�P�Y
� a^� �. n .,_ _ r-i
DI':11\'G' \i�....v;:.�.�.....
Card NO. ..... L!.1D,9.�J......
:� (p �-� (� 3 9. v�
Date (rnonL4
08IB (monfh. d3Y. Y��
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