HomeMy WebLinkAboutMortgage_Koenig"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7 i vear
_. , FOR DEDUCTION FROM ASSESSED VALUATION
Stdte Fortn C37W (R71 / 6-09)
�' �u. areuntea M�re of Lod covemrtea Fu�ance
File Mark
uurnucnoNS: � �
F
To be filed in person or by mad wdh the Counry Aud"ROr or Counry Recorder of the county where the poperty is bcated.
Filirg Dates: 7) Real Property: Must fila dunrg fhe year for which tha deductlon is sought Counry Auditor
2) Mobde / Manufactured Homes not assessed as Real Pmperly Must file during fhe fweNe (72J marths`�j
6e(ae Maich 31 0( each year Me deduction is saght %'�'� �'�nr1 Recardv
See reverse side !ur additmnal insWCtbns end qvalfications. G I° S.�.N J i �+ "
(owrerarmmractbuyer-rTee mreversesiie
T' sVir1 Key rvim0er / legal desaiption
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,�,ad,earma�,�a«ivasor �ge ,c.o�aaao-
Memh 1. arrent yem Merrh 1, wrtenl yeer
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rc m. what is t�! ha esaG sl�ara o1 interen?
If rwne m�em�tl's dfie�ait Nan Nat a( aOpOpn; hW'vam EebM:
o �000. 3ay-oa
aeAness u�aid as d Mortgage / Cantraa
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Addreu of rtnrtge9ee w contract seDer (maMar end sneet �y, sbfe. e�d LP a
Name aT a55iFee or otlw owner rn halEer ol rtartgage
PdE�ass of assignm (numbar aM saeeL �: s+ata, entl LP ootle)
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muMi m InC�ena? ❑ Yes ❑ No
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i i wa cemy �� , mi
oumer / mntrad buyei
Persm auNm�E Cy
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penalty W perjury tt�4 Me above arW foregoing infortnation is true and co
of Ne atorementar���d property on date appliption is filed.
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penm (numbera� sbeeL �}: s+ate. enC
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Iegal a equi1a61e ownrYl
❑ Yes ❑ No
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Is the P��GP+�Y in Ouestim: Mm�aOy Asesed
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llra���er NO.... °�Q/.0...... �
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