HomeMy WebLinkAboutMortgage_Englehardt_N STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN� ownship Year
s FOR DEDUCTION FROM ASSESSED VALUATION
. • Sfata Fortn 43709 (R11 / 6-09) 31 201
�` P�esaibed �y Department IN Loml Govemmanl F�nce
w.
File Mark
. STRUCTIONS: C���� .
To be filed in m� ��
person or by mail with the CounyAudito� or Counry Recorder o� the wunry where the property is located. V
Fdmg Dates: 1) Real Pmperty Must file during the }rear for which the deduction is sought. �y COU N7Y A DI Ol� �unty Auditnr
2) Mo6�7e / Manufactured Homes rat essessed as Real PropeRy Must file dunng the �iV� �r[) months
be(ore March 37 af each year the deduction is soughL ❑ Counry Recordu
See reverse side for additional instruclions arM qualifications.
MP��� (owrier�pr cor�traft buyar- see �esvirliora m re�xrs�yside) n / ��%
Ta�urg
Key number I al Ee:
a�_1'
Monpape/
Y�
what fs his ! her e� share of intemsc?
11 name m remE s dMeRnt Wn Ihat W aPP��4 ��te bebMc
Name M rtwrtBa�Jee or contraU �ul�er, �'�
Uti
ACd2s o1 rtart9a9rx w contraG se0er (number and sUeel, riry, state.
, of assignee pr otlrer owrrer w twlder
ss of astignee (number eM sbeeG d
aPplinnt w.n p(operty in any oNer
y�i�ae�,aa ❑ ves [
cpon approved 4� tlie amount oE
20_ 20_
�
� � �'
appGOtion
RemN number Page numbrl
ydid
unPaid as d Is Me sPd���t Me sde
legal a eW itaWe ame(?
n Yes ❑ No
Ii rnmetl wiN someo�re ather Nan 5pouu. iMkata w0h wt�n
Is tl�e proD�Y m G�an: Arva�aM Ass�sed
❑ Real RoPeNY ❑ Mnually Assess�
Moble Hm�e (IC 6
lll"11VC1' ���... `. `!./.�......
Uo��a�.�z�P�� Ca{�-rd —N7O . .....................
If yes. what countyt What Ta�fi 4�' �/� ��. VU �y
r,o , I- -- - u .� �7
auortoR
2p_ � 20_ � 20— � 2f1
Date (mon�n.
�
I/ We certify uMer the penalry of perjury that the above and fcueguing infortnalion is We and mrteU arM Nat Me appliran[ is a resident of India� and
owner I conVacl buyer of the atorementloned property on date application is filed. �
»R ���) Da[e( deY.Yee�)
., %%`i:': . . � �-r�nG' I � � a �- � - l _ � �
�f, an.
dWy execuSed
Pddress o1 auUror"¢Ed pe�sm (numberaM sbeeL city, sYd(e, and ZfP catle)
UiiD�E
read