HomeMy WebLinkAboutMortgage_Braselton"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R77 / 6-09)
�` / Presaibetl by DeparlmeM of Loral GavernmetY Fllance
� � File Mark
STRUCTIONS:
be filed in O � �
person or by mail wffh the CountyAuditor or Counry Recortler o/ the counry whe/e the property is located.
Filing Dates: 7) Real Pmperry: Must file dunng fhe yea� /or which the deductbn is sought. C�
2) Mobde /Manufactumd Homes rrot assessed as Real Properly Musf f7e dunng the tweNe �72) monfFs �'
beto2 March 37 of each year the deducfion is sought.
See reverse side for addiGonal in � ns and qualificatbns.
Appfiant(ownerorcanNdrl6uyer�see sOiUionsm rseside)
GIBSON
Distria � K� `wmGer �al desarytim —� O O— D O/. � 6 �' O�� RemrO numEer
vF4f0 r � oc
eC vdue of real PoO�Y a of Mortgag e'/ Contra�x77'{{��QQe6tetlriess unPaid as W Mortgage / ConuaU'vMe6teEness unpaitl as d I
7, anertl yrar Mard� 1, wrtent y@�7 /� ____� date af app4cation I
�� iX x�3� �
If ro. what is his / her exari share ot inte2si?
�( INff1E Ofl
��
Pddress of mMga9ee w contract se0er (number and shee4 �fi: s6[e. aM ZIP code)
Name of assignre w dher owner or htlCer ot morigage
Ad02ss W� ee (nu er arcl slree4 �; s+ate�.yid LF mde)
C .LCi
Oces aPWipnt own pmperty in an other It yes. what counry?
munryinlnd'ena? ❑ Ye5 ❑ No
D¢trid7
�.
Counry Auditnr
,Counry Recorder
iRahle avnel.+ �
Yes ❑ No
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