HomeMy WebLinkAboutMortgage_South"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi Year
FOR DEDUCTION FROM ASSESSED VALUATION
Safe Farm 43709 (R70 Hi-08)
� � Presuibed bY DapaM�ent d Locai Govemme�rt F'vian�a
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� aa r,iaa;� �,� or oy �a w�m ure ca,nryaw;ror d u,a �,�ri wna,e ma aovanr � a��ev. - 2009
Filirg Dates: 1J Real PropeRy: Must fJe durmg the year/or which Ihe deduction is sought.
2) Mobde / Manu/actured Homes not assessed as Real PropeRy: Must file duniy the hveNe (12) mmths 6efaa Mm�
the deducfion is soughL O
see ievarse sae�,r edeaoorw rnsm,a;ons er�d Qua�ficer;ons GIBSON
AaoGcant (o»ner oorrt�act dryar- se7EesbiC' m rowrm sideL
- � � - -,.,, -,
Asessed value dreal propeery as d Martgape I CoMracl rt
61arch 7. ameN yaa Mamli 1. curtem year
If no. whaf 6 hb I hef exatl share d iNeres�7
r�� o� re�«d � c�rem uw� u� or �vsmra. �,d�re �ro.�
Nanie d mwigagee Q cantrad seAer �
Address d mortgapee ar rmtad se0er (manber and C a. fo. a
Name d assigiree or ather anwr ar holder d mwt9aBe
Remrd
� -o0 9
7e / CoNree indebtetlness unpai0 �
app6mtion i�i � _ _
If owned with sameo(re other Ihan soouse. inElwle wiM Wun
of assignee (muMOr and abeeL �l: #a�. a�d LPmde)
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couNrv nuaroR
eacn yyeEr
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Paga number
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�P�a tlie sale
aquRabia o�vnBR
] Yes ❑ No
�s me wwaro � o�e�,w,�h r��:�a
❑ Real Pru{�erty Q Mnualy Asseaed
I I We certiFj under Ne penalty of perjury that the above and fwegoifg mfortnation is We and cwretl an0 tIw
owner / mntract buver of the aforementioned poperty on date application is filetl.
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