HomeMy WebLinkAboutMortgage_Shomate^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS coun Township vear
__ � FOR DEDUCTION FROM ASSESSED VALUATION
. . • State Foim 93709 (R71 / 6-09)
S d pry�bed by DeVartmeM af Laal C»vemmenl F�nce
or
INSTRUCTIONS: °�("�Q �^ �
To 6e filed in person w by mail with Ne County Auditor or County Recorder of fhe wunry where [he property is located. MA G�iy� U � 2
Filing Dates: 1) Real Proparty: Must file during the year Por which the deduction is sought. L J Counry Audiiur
2) Mobile / Manufactured Homes not assessed as Real Property: Must file during the Iwefve (72) months
before March 31 of each year the deduction rs sought C. . unty Recorder
l
See ,everse side for adtl'�fional insVUCtions a� qualificafions.
p,pp6rant (ox+cerorcontraC�er- see res�0ons m reeerse sile) �% A / J.
;e0 vdue �t real p�aperty
1, ctpmd yeN
If no. �Mat is his / her e�or�
Key Ifumbu I legal aesrnptwn
o�� - - DO -O��• 8/7- o0
MoRqa9e/ Contraa iMehteEness unpaid az of Mortgage I Cavrac
Marrh 1, wrtent yrar tlate of appGcation
�
r�n If wrtred wiM someone othrJ
It rume on remd'a tliRemn[ Nan that o( appGrant, mdvate Gelow:
tameoimortgageeormnVxtseYer w A • �/'� ---" ! _
Ll ��
Addrea of mat9a9ce or contracl seDer (number ard stree4 �l: sta�. aM LP oode)
Nama o1 assignee or other ow�er or htlAer of rtprtga9e
�.�.
p(ppnJty in any alher
9��
Wtat Tari�9 De
Remr � P�n/ % �
btedness unpaid as d Is Ne eppfcanl Me sde
Iegal ar equilade owne(?
Doo� ❑Y�❑Na
spouu. i�'xate wlth whan
Is Me ProPertY in Vuestim: M�ua%' Asvssetl
[�RealProPeKY ❑?u°�ualh;�
S/�D%I�/�/� 'C/-��C .!�
�.cJ� S
/d �y 7�
nea �ti....___'
tor arrent yra(.+
r.m