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" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T` n ip v
_ FOR DEDUCTION FROM ASSESSED VALUATION
Slate Form 43709 (R10 /11-08)
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INS7RUC710NS: Fle Mark
To be fded in person a by mail witlr the CauNyAWilor d fhe county where the poperty is located. `�j yy
til"mg Dates: iJ Real Property: Must Ide dwing the yBer for whnch the dedudiwr is sougfit. /� '� 6� ,��+�
2) Mobile/Manu/ecLned Homes rrot essessed as Real Property: Must file dunrg tlie hveNe (f2J monfhs be�llarch 3fouNT� �rD�TOR
the deducfion is sayht JUfJ C
See reverse sde /or e0dd"anal inSLudions end qtrdfifxafions
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as d Is hB app4ad Ihe sda
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❑ Yes ❑ No
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