HomeMy WebLinkAboutMortgage_Broz"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ ; FOR DEDUCTION FROM ASSESSED VALUATION
Sfata Fwm C3709 (R71 / 6-09)
, PresviEed by DepaRmeM M L.acal Govemment Firrence
� File Mark
INSTRUCTIONS:
To be �led in person or by mail wiN the CounryAUditor or Counry Recorder of the counry wheie the properry is located. A P
Filing Dates: 1) Real Property Must fJe during the }rearlor which fhe deductlon is sought.
2) Mobde /Manufactured Hwrres not assessed as Real Prt�perty: Must file during the M1reNe (72J monMs �
be(ore March 31 of each year the deducfion rs swght. �
See revers�aide foraddifionaf instnxlions andqualfications. niasnu i
�
��� �
�������
7, anall[ yrat
what Ls ha / tw� erarl
Auditor
Recorder
r/�q�,�, _ _ OC'7-�{� ��o(o-Oa � d P�el� '�
o�
Abrtgaga / Contraa ness unpaid az W Morigage / Con�aC hWebted�mss unpaitl as of Is Ne applkant the sda
March t. arteM �/� tlata W aPP�+ � or M�itade axnen
�1 ri-/ �h� n Yes n No
Drawer NO.�Q l i�
.......
�
Card NO. ......3�..........
�$ � I I, 3'13. °°
,
Oces epplifant own popeny in any oNer I If yes. what
munryinlMana? ❑ Yes ❑ No
.0 f
i La �oae�
M owneE with someone oNer Cun spouse.
Oistridl
Is Ihe p�ope+ly in Qwstion: MmieOy As5e55eE
❑ Rea� aroperty ❑ nrmuany w�ssed
0.bWle Fiome fIC 6
Has this tleCUUim Ecen m9uested m p�aprlty
farw�rerrtY�n r-� _' r-� .
�