HomeMy WebLinkAboutMortgage_Brasher"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C 7ownship vear
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• State Fam 63709 (R71 / 6-09)
� ! Presaibed by Departmerd o1 Local Govemmerd Finaxe
�µ File Mark
�INSTRUCTIONS:
To be lled in person w 6y mail with Ne CountyAUditor or Counry Recorder o! the aounty where the pmperty is located. O� Form e
Filirg Dates: 1) Real Properry: Must file dunng the year for which Ihe deduction is mughL C� unry Auditw
2) Mo6de / Manulaclured Hames rrot assessed as Real Property Must file dunng the fwelve (12) months
before March 31 0/ each year the deduction is sought. ry Remrder
See reverse side for addi[ional inshucGons arM qualificatons. GIBSON C
zd vahc dm� poperty as d
1, tlnP1tt yeaf
Ihat is ha / her erar2 share W i
3 on remid is dRferent lhan Na
ot rnutgagee w mntraa seller
CJ 1-1 — 1 O J v l (iCiC.
Mortgage / Contrarl ind�tedness unpaid a o(
MarG� t. wnerrt yem
number � Page num0ei
im78itl as of I Is Ne eGP�� tl�e sok
1eg21 or equitable owrM
❑ Yes ❑ No
wmen�e atMJ than spouse.
Is IM property m Question: MmuDy Assrsstd
� Reel Pfope(ty � MnuallyAsse�ed
Mobde Fiame fIC 6
� �� V � /�� �'y� �j ,
Pddtess of mort9a9ee or mntratl se0rs (nwjNer and shee4 �'M state. ai. �/7.� NG/L/ /C..�� �' J
Name ot ats'ry�ee or other ownx w halder ot mort9a9e //y"U (/,��5 / 1� G
n � ��
AACress oi assiqnce (numberaM slree4 a1y, slate, and ZIP catle) // ,/� /'/
�U ��
Does aPd�nt wm pmperry in any other If yes. whal munt
counry m IMana? � �,� � No , _
]im Eeen requested m G�Y
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