HomeMy WebLinkAboutMortgage_Hurst� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
. FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn C3709 (R11 / 6-09)
� Presaibetl M�rtmeM of Lo�l GovemnnM Finance
I
INSTRUCTIONS: qadvimp Z
To 6e Ided in person a by mail wiM Ure County Auditor or Counry Recorder o/ Ne oounty where the properry is bcated. F 1 1 0'
FiNng Dates: 1 J Real Property Must file durirg the year (or which the deduclion is sought County Auditor
2) Mobde / Manufactured Homes not assessed az Real Property: Must Ae dunng Me twelve (12) moriMs
before March 31 of each year the deduction is sought.
See 2verse side 7or addiUonal instniclions end qualifications.
MO��� (9�3rmnvaC Duye�- me msbrbwa.m rererse side) .. .
�
mimOer
Assessed r�ue af real properry as N
Marth 1, aRe�rt year
tt ro, wiiat is h'a I trer e�oG sl�ara of Nte�?
tl nartre on reard is dAt�t than Nat W appl
ie m mortgaBee a mnrae se9« O��
_ - ato. 6 d �
itraa inCeMeCneu unpaid as af Mongage
n yrar aace oi a�
��0�
ot mom�x)ee ar mntraG se0er (n�i and streel �Y. s��.
name rn asgnee w omu owner n rwiaer a morcg
PdC2ss ot asvgnea (number anC street �: s�M,
pces ePptimrV own ProVertY in airy oNc
m,�uy� am�aa
❑ ves ❑ o
�
Deduction appwed In ihe amount of:
20 20
num0u PagenumCc
) �
a d Is Ne ePP�f Me st
Yes LI No
someone otMl �han wW��'udimte wiN whom
- 6 tl�e P�Oe+�Y in Guettian: M(waDy Asm�+.d
I PfopeM1y � AnnuallyAssessed
MoGle Fiortie QC 6
LPcode) V\ O f `/ _ 1 5 1�
If yev, what counl�
� � f ao, SoD . °0/
Fi�]
I I We ceriify under Ue penalty of perjury that the above and fore
owner I contraa buyer of the atorementioned property on date a�
..�.�,si.,�.,.,ehnai.��i .
PersM
d aGW�^t (numbe` an0 sbee4 �Y• state, aM LP ca
7e� (wm0e�and sbeet c+N. amfe. an0
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