HomeMy WebLinkAboutMortgage_Walker"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES ship Year
,_ s FOR DEDUCTION FROM ASSESSED VALUATION
: . � Stale Fortn 43709 (R77 / 6-09)
�,�,� 1 Presmbetl q Departrrierit of Loral Govemment Fu�ance
�NSrRUCnoNS: FEB 2 3 20�1��e Mark
To be filed in rson or b mail with the Coun Auditw or Coun Recorder of the coun where the ro F�"`� ���
Pe Y N h ry P PertYisl°�7(ed
Fiing Dates: 1 J Real Pmperty: Mus[ !le dunng fhe }rear (or which the deduction is sought C• �• County Auditor
2) Mobde / Manu7auured Homes nof assessed as Real Property: Must h7e dunng the twelve (12J months
before March 31 0! each year the dedudqn is srought ounry Reoorder
See reverse side fa additbnal instmctions arrd qualificatons. GIBSON COU N AU 0
AppG�ant (o�mer a cont2C buYer - see restri�ora m re.reru vtla) ._ )! 1 �. l_ il 0 w.
'1 / i/ /f _/ w �
�
Key number! legal desaiDtion Rernrd num6er Page wmEu
a _aa -�a - 300 -oo�. 3�9 - oa �/
z0 vaLe d rral pmpaty as o7 Mor(qage / Contract irdehtetlness unpaitl az ot Mortgaqe I Contraa uWebtedness �mpaitl as of Is �he applirent Me sole
1. amnt Y� Mard� 1, ai�rt-e1nt Y� .-7 data of aPP�� �gal at eWitabk ox+iM
p� Q � v ❑ Yes ❑ No
rfiat Is his I M1er e�aG share oi intriest? If awned with someone dher than sDOUSe. 4Wkate with whom
Name ot rtartgagee or mno-au se�u
Address of rtnrtga9ee a contraU se0er (numbrl erM stree4 �'dl: sate. ard ZIP cnde)
Name N assignea m oNer owner rn Imldu of nqripage
p�d� a� r and hee; ary, sfaie, aM
oces evW�faH or.,i woae�cr in a�y rnne.
munry in IMana?
❑ Yes ❑ No
De�uction 2pp�oveO In Ne amouM af.
0
COl1NTY AUDROR
zo _ � zo � 20 � zo
s;yoan,re a ry nw�m�
i/ We certify under Ne penalry of pe " ry that the
owner � contrad buyer of the afwementimed pro
full
L
PP�SOn auNO�d
counry
iul foregoing in(ortnaUon is We �
date appliration is filed.
autharaed person (number a�W sbee4 �3: stafe, and ZIP code)
0
�
p�ty in question: Mnua�1' Asessed
RvPertY ❑M�ually%�e�ed
�7
Dra�r�er NO.: �i�.�. ��........
Card NO. ....0 �.�..:......
`R�o�,�� 00� . � .
. . � . . 'i
. . ^ . , . � .
. i-__,.._._.. ... .
�J