HomeMy WebLinkAboutMortgage_Moade^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ _� FOR DEDUCTION FROM ASSESSED VALUATION
• State Form d3709 (R11 / 6-09) �� g �
�,,,, r PresoiteE by Oepafiment of Lad GovemmeN France �
�� File Mark
STRUCTfONS:
� be filed in y n, . Form Ned wflh:
person or b mail wifh the CounryAWitor or Coun Reowder of the countMH¢qeihsor�� is located.
Filing Dates: 1) Real Property Must file during the year (or which the deduction is so�n�AF' ' � unty Auditor
2J Mo6Re /Manufactured Homes rat assessed as Real Property: Must file du(�'n the eNe (72J monNs
before March 31 of each year the deduction is sought. C- J� ❑ Counry Recorder
See reverse side for addifional insWctions and qual�cations. \
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KeYnmiber/legaldesmp' �/OC_O�O—�(�/ "l��/.�0� R�d�r�( P� 1 V�
Mor�e / 'udrbteEness unpaitl a, of Mongage I Contrx7'vdebtedness �mpaid a d Is ihe appfu�t Me sde
Ma� 1, ,�,,r�/1 eate of aPP�� � a�w�� �
r �C��� n Yes ❑ No
—"- -"�_"-� w.., x+m N aoo�nt, rt�Ainte Debw.
Dra�r�er NO..... �. �...:.......
Q� e�a��
Card NO. .... �: $..`'�-?......
If owned wiM mmeone other Ihan spouse,
IS IM G�PQrtY N GU25�JI1: Mfll18� ilS52S5Cd
❑ Re� �o�rty � aII,�,any a�d
Ooes epplicant ovm pmperty in any aher If yes, wha[ couny? What Tanrg DisVia? Has Nis dedudirn Oeen requesteE on property
munry in Indena? ❑ Y¢s ❑ No �r W�� �� ❑ Yes ❑ No