HomeMy WebLinkAboutMortgage_Morgan (4)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
r__ • FOR DEDUCTION FROM ASSESSED VALUATION
Stace Fortn 43709 (R71 / 6-09)
�' �w � PresaiDed Gy Departmettl of Loral GovemrtreM Fuance
�STRUCTIONS: �
To 6e filed in person or by mail vnth [he Counry Auditor or Counry Remrder o7lhe county whe2 the property is( C t �
Filirg Dates: 7) Real Pmperty: Must file durirg the year for which the deduction is soughL U
2) MobAe / Manufectured Homes rat assessed as Real Property Must file dunng the fwelve (72) months 8
6efae March 31 of each year the deducfion is soughf.
C �. m.�
See reverse side (or additional instructions and qualificafbna (
nppfr�t(mxneroroonaartbuyer-seeresqictioncmreverseside) . GIBSON
X
p'openy as d
Ii m, what z his / Mr exact
It name m� is ddferer
Name of rtwrtgagee or contrap seller
Address of matgagee ar mntrad se0
Iitant own
�naana?
Key rnanGer /ifgalOesGSpUm
a� � �9 -�9 - ao �
hbrtgage / Contraa iMebteenPSs
Mart�h 7, arter�{.yCar �
!//
M snee4 �4Y. s�ate,
a� Ne�
Yes ❑ No
sbee4 �ity. srdte, and ZIP cade)
Year
"� Counry Auditor
❑ County Recorder
) COUNTY qUDITOR
a��
Record numhc Page numDu
_ oo/. 300 -o �-� 7�0 1 5�6
iaid as N Mortgage I Con7aG 6iEebtedness unPaid az d Is Ne eP�t ihe sde
Cate ot aOP�rim kgal w eWitable awneY.�
� ❑ Yes ❑ No
If owned xith someor�e other tlwn spouse. mdirate vrith whom
�Is ih property in Questian: MnuaAy AssesseE
�iaoaero 0,�,�iyas�a _
DistritY?
D����.;���-,o:.o1Q4►:..:......
5���7 .
Cflf(1 �0. .....�....... �......
�3 �+^k � `�2 3� `_
I COUNTYAUDROR
DeducUOn approved in the amoum of: .
20 20 20 20 _ 20 20 20
SignaWre of Counh Autlitn Caunry Oate (rtanN, day, Yea�
C-T•
I I We certify urWer the penalry of ry ihat ihe e and (oregoing infomialion is true and correct and that Ne applirant is a resident of IMiare aM
o�mer / mntraU buyer of the afwe entioned pm rty on date aDd�� �s filed.
Full revd€nt of aQbGrant (numAer �M sheet, ti(y, state. nd ZIP code)
7�4�_(t=—.5�/C L� �7'� �/�a/I(/i�
Person au0ro�rzed Dy dWy ezew�AttwneY � M IC 67.1-12-0.7
Pddress of a WiwseC person (num0er aiM street, pry, sfate, aM ZIP mde)
Daie fmOnfh. daY. Y3a�