HomeMy WebLinkAboutMortgage_AuberryY
^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun s r
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R77 / 6-09)
�' � Rrsaibed Oy DePa�M o1 Loral Govemmeril Fuunce
J6,
wsrnucnoNS:
To be filed in person or by mail with the CounryAUditor or Counry Recorder of the county where fhe pioperty is focated. ���
Fil'ng Dates: 1) Real Pmperty: Must file dudrg fhe year for which the deduction is sought. �mR���p�y�u itnr
2) Mo6ile / Manufactured Homes not assessed as Real PrtipeRy: Must h7a during the hvefve (72) months
6efore March 31 of each yearthe deduction is soughG GIB ON �UA��iin(j�Q��
See 2verse side (or addiianal instfuclions end qualifications.
.I
Key rnrtntc / legal
-� � �G/ %O —Q�
As�e.d value dreal p�operty as of Mortpag e/ Coniraa Intlebtedness unpaid as of Marigage / Contraa udehtedncss �mpaie as o( Is ihe epp�rcant the mk
Mard� 1. arient ym Mardi 1. (a7rt�eCnt year tlate of aPP���^ �gal or eWitable owneR
n , J ��Q� ❑ Yes ❑ No
ro, what b his / her e�r1 share oi u
nama m ieooid'a QRferent Nan tha
ame d �mtnaaea or crntrarl se�er
Pddtess of nwrVja�jee w mntraG sWer (numher erd streel, city,
Nama M assignee w othu awner ar halAer M morigage
Mdress ol assignee (/wm�� and streel, cdy, sfeta,
c�vem � ariv omer
❑ Yes ❑ No
De0uc0on eCW�'� u� Ne amount a(:
someorie oUrer Ihan spouse, Indirate wAtli wtom
,� AUB�/, Acc� �
���, L
w �a�� �3 /
COUNTYAUUROR
20 _ 20 _ 20 I 20 _ 20
mne N CounN AuCitw Caunry
Cx P�7P+�Y in question: MnuaDy Asessed
}j2ealPfoPeKY ❑��h'�
duction been reGueste0 m G�Y
� ❑ Yes ❑ No
20 _ 20 _
Date (rtanN. daY Y��l
I/ We ceNy uiWer the penalry of perjury that the above aM foregoing infortnation is we and correct aM that Ne applinnt is a resideM of Iridiana ard
owner I wntrad buyer ot the afwementioned property on date applicatlon is filed.
70a�Olawne(shAreme)n n . Date(rtwRh.daY.Y��
state. eM
Person auita�rzed �Y d�A' exen�tetl
person (number arM sbae( Uy, sla(e, eM ZIP cade)
��