HomeMy WebLinkAboutMortgage_Bush�
"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS u T sh ear
:__ FOR DEDUCTION FROM ASSESSED VALUATION
:• Sfate Fortn d3709 (R71 / fr09) .
�,,,� � Pres�ribed by Departmertl o1 LoW GovemmeM Firence � .
File Mark
INSTRUCTIONS: . �
To 6e ned in person w by mail wiN the CountyAUditor or Counry Reoorder of the counry where the property is located.
Fifing Dafes: 7J Real Pmperty: Mu51 file dunrg the yrear tor whith the deduction is sought. � nty qudiinr
2) Mo6de /Manufectured Fbmes not assessed as Real Prt�peerfy Must file dunrg the tweHe (12) rzw&tBSON 0 Y A U61TOR
before March 31 of each year the deduction is sayht Caunty Remrder
See reverse side for additional instructbns and qualifications.
Appi' �(owne� mmnfraC 6uyer- see ' R'�ns m re�eerse sde).
�o.,� T � � ,
A�ssed vaNe of mal PWeM1Y ��
MarU 1. anent ynr
tl ro. whal Is his / hw erxt shara o1 inG
If name m mmE e 6lteran Nan Nat c
Nama of mrtgagee or mncaU seqer
�������,���
���d��
- ia - os- y
^ Mortgage / Contract'v
Mamh 7. arte�rt year
�
aN, mEitate Celaw:
7� .
r�,am�e�a��,wnm��r�a
ACOrass of assig�e (num6er ard atreet ml: �. and Z/P oode)
oo/. I 8� - o d 7
ss unpaid as d Mongage / ConraG
v
��o a�
as d Lv tlie ePP�^t Me soie
kgal a ew���e ownert
❑ Yes ❑ No
wmeone dhel than sPW�. mdrate wiM �M�mn
Qk prupertY m Quesbon. MrvieAY Asscssed
�Fj,neal PmpertY � �Y �
Dra�vcr \O.. ��.�........
Card NO. .....cJ. o? 1�.........
�,���,��,.��Y�,� rc�.����� ,�. � 1�8 �50. � _ .�
county�nlMana? ❑ Yes ❑ No , ,_, ��.+ ❑ No