HomeMy WebLinkAboutMortgage_Williams (3)-"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
FOR DEDUCTION FROM ASSESSED VALUATION
� Stafe Fortn 43709 (R71 / 6-09)
`,,,, � Presmbed trl Departrtcb o/ Lural GovemmeN Firwice
INSTRUCTIONS:
To be fied in person or by mad wifh the CounryAUd"ROr or Counry Recortier o( Ne rounty where the properry is .
Filing Dates: 1) Real Property: Must file dunrg the year (or which the deduction is wught
2) Mo6de /Manufacfu2d Homes rpt assessed as Real Prt�peerty Must file dunng the hvelve (72) monMs
before March 37 of each yenr Ne deducfion is sagh[
See reverse side (or edditionel instnrctions and qual'dications. �
AooWeMlnwiermrmvaCbuver=seerasbicG'w+smrevrlsisfel . . �. , .. —
i5tritl Key rnmDer I k9al EeSVipl
f�2h�eufrealPW�+tYatd Abrtuage/COn
ammym Mamh t, aurer
ro, xmet is nis � tkr e�O
Name d mort9a9n or cmtra�Y se0er J I
Pddreu ol nartye9a ar contrad sr�er (number aM strce4 �1: smte.
Name ol assignee or oNu awner w holder d imtgage
PdCrava of a�gnee (num6er and stree4 �Y• sfate, entl LP ootle)
� � Y
i as v Mortyage / c«iraa
date of eppGmtion
L � 6c�4���a�.
�
Yes ❑ No
spouse. rt�GlfPte wIN �vMm
�g (�IG �CfC� Yf VUE�KII: MIIIIB�Y AS52�
❑ Real PmpertY ❑ ?±inuaMassessed
Oces ePplirrnt v�n Wo7�Y in any oUer If y�v. wliet m�mf/1 � - � A�'l, I J fw anent YeaR Oaen 2Questetl m prapeny
muruy m Irdmna? ❑ Yes ❑ No Y�' � J���- C ❑ res ❑ No
�„ , ;q,•.. �n �,� �
'y(i�' ��..
oea� a�m n ma �� or.
�°— �°— a��D���a° p— �°—
Sgreme d Caund Audimr Counry Dam (monM. OaY. Y�A
I I We certify urWer Ne penatty of perjury �hat the above and foregoing mfortnation is W e end correct arM that the appli�ant is a tesiderrt ot IMiara aM
ovmer I contraG buyer of the afwementioned property on date aDpiication is filed.
addrass U app4ant
��
�q��,
.Crmet �1: spea. aM LP m0e)