HomeMy WebLinkAboutMortgage_Jones (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
�, � FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate Fortn 43709 (R11 ! 6-09)
S f p�gQjp� py Departrtrent of Local Governmenl Frence
�w. I
lSTRUCTIONS: F� fl� �:
To 6e fifed in person oi by mail with fhe CountyAuditor or County Remrde� o/ the county where [he pmperty is located. MA 1 Q�9
Fifirg Dates: 7) Real Pmperty: Must �le dunng the year for which Na deducUon is soughG 1� CSunry Audimr
2J MobBe / Manufactured Homes rrot assessed es Real Property Must fife dunng the tweHe (72) months C.'�,,,, �����nry Recorder
6e(ore March 31 0/ eadi year the deduction is soughG "�°`L'�il� �"
See reverse s�e for addrtional instnicUons arlp qualificatrons.
Appfu-am( roroonnsrl6�+er-see onreyQseSde) /1 �i���6TT�� I
X
AssesseC rahre dreal popa^,4ks d
A7arU 7. amrsR Year
If ro. Wh2I 6 h6l h¢f fi2i 511818 O
�r rwre «� remte s emermt u,an u
iher / kgal d _P� �D ' �/ / - � /� brs Page numbrl
6
Mor(yape / Cantraa iMebteO�ress unpaitl as d Mongage I ContraC mdebteCness �mpaid as o7 Lv the eppi'itant Me sde
Mard� 1, artent year date of app�xation kgal n epuitaNe ownerl
� ❑ Yes ❑ No
IF awried wPJ� someone oNU than spouse. iMicate wM ri�wn
u�dvate Dela.v: Is tlie D�PenY in 7uestim: MnuaM Assessed
� Real PfoPeKY ❑ %'?���1!�
Name of morcgagee a mnbact se�er ��
Atldress of �mrt9agee or mnhad sWer (nuMeren
Name ol assi�ee or oNer ovmer w hdder of morig
PLdress of assignee (number arM stree4 ury, sm+e.
Dces epplimnt am property in any oNer
munrym�ndana? (� Yes ❑ No
20
the amount of:
2b _
sfteel, cRy, 5t2te. a�tl ZIP COOe
3e
M Z/P code)
C
If yes, what counryR
COU
20 I 20
J �7 �� �U
, What Tavig DisVict7
AUUROR
��� � �:ry,��� "
I/ We certify under the penalry of perjury that the above and foreqoing intortnatlon is
owner ( conVad buyer of ihe aforemeMioned property on date applicatlon is filed.
Sp��2Nre (awrrefs/rp,�ertre)
r ! e 1 \ . .
�ry
by Euty execueed Power
l
Pdtlress ot a Wiwaed pe�sw� (num6er arM sbeel. dry, state, aM LP code) .
Has Nis deduction been re9ue5teE m propeM1y
forWrtentyeaR fl .. 1-1 �
2(1 _ 20 --I 20
JON��, .S�jl-(_�.)
U�c.��'� 1�
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