HomeMy WebLinkAboutMortgage_Lough^�+ STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
_. FOR DEDUCTION FROM ASSESSED VALUATION'
Sfate Fwm 43709 (R71 / 609)
`�w P25aibetl N' Oepartrt¢A of Loral Gwe.mrtreN Fv18nce
Coun Township Year
F'
INSTRUCTIONS:
b be filed in person or Dy mail with the CounryAUditor or Caunry Recorder o� Ne county where the property is located.
Filing Dates: i) Real Property: Mus[ ke during the yrear Iw which the deduction is soughf.
2) Mobde /Manulsdu2d Fbmes not assessed as Real Properfy: Must file durirg the hvelve (12J months
6etora March 31 0/ each year Ne deduction is sought.
Auditor
Recorder
See a siCe for additional insLUCtbns and qualificafions.
o-aa onrererses;e OUNTY AUDITOR
Keyrwmberlle9alOe�pO I y.-�v —4-� �v �• 5g/ �V RemNnu� Pagewmber
CJ�
I AtsesseG rahn d real pfapeny as d My�yg e/ Cantraa'udrbtetlness unpaN as of Mort9age I wnaact �ndebteMCss impaid as d Is Ne app9rant Me sde
IMa�rh 1. a�tl yrar Mar� 1. arte�/ O`./ V date of aPP�� � O YeSe Q
n m, what Fs his � ner eiaa sna�e a mte�asc7
m a�tl's 6RrRnt tl�an tl�at
Hame of nnrtgagee or aontrari
--D1'111'Ci' \i�....":Y.I.�.........
ca��� ��o. ...as3y.........
�:
�e,
If owneO vrith som�re othei Ihan spouse. udkate wBh vAqm
Is ttie property in QuesOm: MnuaCy AaesSeE
❑ Real Property ❑ nrmuanyl�ssessed
$ G( � a� v. o� s..�� ���y+ I w�� r�,� o�� � rm a� ,�"�°�r e� �a��a �, w�r I
� ❑ Yes ❑ No