HomeMy WebLinkAboutMortgage_RileySTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
„ FOR DEDUCTION FROM ASSESSED VALUATION
$tate Porm 63709 (R71 / 609)
� PtesaiOeE EY �rd al Loral Govemmerrt Finanm
� i e Mark
INSTRUCTIONS:
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To be filed in person a by mail wiN the CountyAuditor or Counry Recorder o( the counry where the property is located.
Fitirg Dates: i) Real Pmperry: Must file dunrg Ne yea� /or which tha deduction is sought. � Counry Auditor
2) Mobde / Manu/aUUred Homes not assessed as Real Property: Must file during tl�e hveNe (12) rtanfhs
befwe Ma�ch 37 0/ each year the deducDOn is sought ��5.! ��-&4� �
Seereversasideforadditiona/instruclionsarMqualfiwtions. _ ,,,ecnu rt(111NTY AUDI
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Name o( rtnrtgagea or mnuaU seller
Pddress af mortgagce w mntraG se�er
Name ot asvgnee w Wwj ovmer or hol
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naaress
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narcuaga! contraa inaebted�
htarch 1 wrtent yrar
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tridifata Eebw:
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anC LP oode)
tt owned with :an�ne othu tl�an
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unpaid as of 6
Yes LJ No
K pioperty in puestion: MmtaOy Asaessed
Real RopeAy ❑ lvmuallyl�ssessed
e.wbae r� nc s�.
Has Nis EetluOim Ecen
for Wnenl YeaR
P�Y
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IDate (monN. daY• Y'��
i ard Nat Ihe applitant is a resideM of IMia� afd
,�d� Y�63
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