HomeMy WebLinkAboutMortgage_Lingis/'
� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun wnship vear
__ FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn C3709 (R11 / 6-09)
�,�,� � PrrsviGetl M DeP���LL of Lnmi Cmvemmertl Firence
File Mark
�STRUCTIONS:
To 6e filed in person or by mail wifh the CountyAudrtor or Counry Recorder of tAe county where the pmperty is located. F� �
Filim� Dates: 1 J Real Property Musl file dunrg the year lor which the deducfion is soughL C'J. p,�ditor
2) Mobde / Manulacfured Homes not assessed as Real Property Must file dunng the tweHe (72) months ❑
6efae Mamh 31 of each year the deduction is swghG G IB ef
See reverse side for edd'rtional instrucGOns and qualll'icafions. ITpR
AoofxaNfowrer bactbuver-searcstnrl.urssonreversesQ�l� .
i � � t�'
.aWearealpopenYaof A1or�qage/COntractintlehtea�
Mamh 1. aman Kar Mart�h 1. artent year
If ro, what is his I her e.ad share oi interest?
11 name m remrG a 61t�t than thal of appOCaN, uWicate Debw:
Name ot mortgagee or m,tract sel�e, � A/c�-� i�
Ij_ f
ACdrea of morn,7agee ar mntraG se�er (num6ei and streeG �Y. stare. aM ZIP ca
Name of assignee or other oxner or tmlder of mortgage
Adtlress ot assgnce (numberaM s1reeL cily, slafe, and Z/P tode) °/ //
tirant ovm pmperty in any oNer
�lld[if13�
❑ Yes ❑ No
DeEuctirn apprwed'm Na amount oF.
20 � 20
5igrenne w Cauih nuanor
It yes,
�
20
NRat Ta�drg
mnieane
20
I I We certi(y under Ne penalry of perjury Nat the above and foregoing infomiation is true ar
ovmer / mntract buyer of ihe aforementiw�,W property on date application is filed.
�naNre(ovme/shAneme) ._ �% ' � �
of Altart�eY a bY IC 61. b12-0]
Adtlress of autlrorrzed persm (number aM sheet �: slare,
Recotd � ber
�mpaitl as of Is Ne a
_. ��
Yes LI No
propertyinQuestiCn:MnuaDyASSessed
e�i aroaenv � � e �
Has Nis fL
(Of WrtH1�
2b
y
Eeen requesteE on P�WertY
r�
L�n/G1�s (�'1a-�p-u,��
I� f-1 �10�
..a . ... ni�i