HomeMy WebLinkAboutMortgage_Hauer"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS cou sfi v
_ FOR DEDUCTION FROM ASSESSED VALUATION
S�te Fartn 43709 (R17 / 6-09) �
` PresaiOetl q' DePerlmeM of Loral Go�.emmeM Frw¢e
�«. �
INSiRUCT10NS: F� � �:
To be fiied in person or by mail with the County Auditor or Counry Recorder o/ the county where the property is located. /�,(%_
FiNrg Dates: 7) Real Praperty: Must file dunrg fhe year (or which the deducliwr is soughG �,--�J��'o(�"Auditor
2J Mo6da /ManufaUUmd Homes not assessed as Real PiupeAy Must �le during Me hveNe (72) month� IBS N C�J1N'PO�RWIBg��
before March 31 o/eacA year Ne deduclion is saght.
See �everse side for additnonel instnictions antl qualrficatons.
Assessed reSx d real p�opnq aa d
A/mrh 7. aneru Year
n�.��m�����a���
M nama m iemd e dAfunnt than tlut of appl
Nartre af rtnrtaasee n contraa sener �
PdEress of
s/ kgal desaiDtion Remrd numbn+ Page nur.,ber�
-a3-o�-3oi-000.���-009 0�0 ��
Mart�h e artmt �intlebtetl�msa unpaid as d 8ortgage � mCebtedness �mG� es a! � n� e awrM
� O . ❑ Yes ❑ No
rc w�,ea wrcn som� —
�Jyju Ei2, A.s��y /�
R 4iEit�te Oebw
NAu� ��,
� v contretl srder (numbr� and strce4 �N: stam, and LP code)
rt�ortgage
rdy, slate,
�Q/D �3�is�
Dp¢y e�q&anl v,vn propMy in any otlrer If yes. what muntyl I 4Mat Ta�dfg D'abiU9 I Has NB dedutflm Eeen rcquesteA m pmp�tY I
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