HomeMy WebLinkAboutMortgage_SmithSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C� ear
_ FOR DEDUCTION FROM ASSESSED VALUATION
StataFam43709(R70/N-08) J N 8 2009
y w. � Presrnbad OY �M�en� d Lod GwernmeN F'vunm
INSTRUCTIONS: '—YnF'���
To be filed in person or 6y med with fhe CaunfyAuditcr d the county wheie the propaAy is IocafeC.
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WingDates: iJ RealProperty:Musi/deCUringtheyenrforwhichthedeductionissoughL a1890N COUNTY AUDITOR
2) Mo6de / Manulactmetl Homes not ascesse0 as Real PropeAy: Must fde dumq tl�e tweNe (12) months befae Ma� 37 0/ each year
the detluction is soughL
See reverse side fix additional ins6udions and quafi6cations
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7. autenl yea
1( tq. what is hc / ha avatl shara of inb�a5f7
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Aderess d mongapee «
2 ia,3oa-oo a.
r/ Cmtad iMeWeArress unpaid as d
ameN year
� 90o c�
I( pmed
llqn IfWI O(�rG. edlmOB bBbw:
Name d assigree or Wher wmer « hdder d mwt9a7a
Pdtlress of assipnee (rwmDOr and shccl. tilY• sbfi. arM LP wdc)
Ibtedness unpaid as o( Is the appfi�aM ihe sde
legal or equrtabla a+rmeR
❑ Yes ❑ No
sw�e. indicata wilh wtwm
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DI'fl1}'C'1" �r�.. �
C:ll'(� 1���. ....�,i.l
� a�7.000. O°
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I� an �na�a Om Y�aner I x yes. wui mubr? I w�u� rax�ng ouma? I ro� i� �a�,on been rea�esied on pmoerty I
❑ No ❑ Yes ❑ No
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