HomeMy WebLinkAboutMortgage_Henning"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ � FOR DEDUCTION FROM ASSESSED VALUATION
�• Slata Fwm G3709IR17 / 6-09)
, � P2soibeE Gy DepartrtreM af Lod Govemment Finaxe
File Mark
INSTRUCTIONS:
To be fiied in person or by mail with the County Auditor o� County Recorder o! the counry where the property is located. F �
Fi/irg Dates: 7) Real Pmperty: Must file durirrg the year for which Ihe deduction is soughL C� dROr
2J Mobile / Manufactuied Homes rrot assessed as Real Property Must file �unng the tvmlve (12J months
6etore March 31 oleach year Ne Ceduction is sought. ❑ er
See reversa side for additronal instnictbns end qualrficafions.
- � r � • -
COUNTYAUDROR a'`%� O �
�Deduction ePw� 4� Vre amoum oE � I' il �1' C 1' � � . . . . . .. . . . . . . . . . . ..
2� � 2�
I I We certify under Ne penal
owner ! mntract buyrs of the
Sigrewre (o�marS�i�ne) i
�
� zo 5 —
c��-a �o. .... 3t�y.......... —
Caunb d (JJ� � ��" �
bove and foregoing infortnalion is W _. _.._ ,...., � ti vyy�w�n rs a resiUent of I`Wiana arW
rty an date application is filed.
Date (�mnth. LaY.Y��
and LP ootle)
by duty ezeatetl Pawer W AlmrtieY a M IC F7.1-12-0.7
fdtlress of aWwrseO person (numDeraM stree4 �y. sbte.