HomeMy WebLinkAboutMortgage_NicholSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS c owns v
FOR DEDUCTION FROM ASSESSED VALUATION
Slata Form 13709 (R70 /11-08) q
� � Prasaibed by OepaMient d Loral Gwemmerit Fearos U N J-�Q �
INSTRUCTIONS: File Mark
To be filed in persan or 6y mad witli Ure CountyAuditar d the oounly wireie the poperty is kcated. ��
tiling Dates: i) Real PropeAy: Must fde during the yearlw which Ihe deduc8"on is sought.
2) Mobr7e /Manulacturetl Hortres not assessed as Real Property: Must file durimg fhe tweNe (12) monfhs hefn� 1.l��e���R
the deduction is sought. (ilttSUN
See reverse side lor addifional insWdions eM 4�lifications
Mo§�11(4T^erdmN�aclWryw�PeresbiQio9l�o^m�eiaeside).. . _ • . .�
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tl ro, what o his I her e�ad ahare d iNaresf!
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1, �vrrem year
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M iama an reoord is QdtaraM ihan Ihal of apV�l indimle bebr.
martgagee n
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Name a( assigrree w oNer owner a hdder d mortgapa
d�ignea (rrurrborand sbcef. a»: ffid�, aM
propeny in arry
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N oxned
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SpIXISB,
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a
r� u No
P�aeM in Queslian: Mn�aM Assassed
3al P�opeAy Q MnuallyA55esseC
Mo6ile Home (IC fr1.
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Dra�ver i\`O..c��p,
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couNn nuaro
DeduGion a0v�oved in Na amouM d: ��"1 / �� '�1 -'
Card \'O. .... oc� j, _
zo � zo zo _ zu _ . . . . . . . . . . . . . . .
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spna�ure a cwnN awnw ca,n�r oa�e lmmrn, dar, r�
I/ We cer0(y under the penalty of pe�ury that ihe abwe aM foregoing i�formatim is true and carted anC that Ihe appficant is a resident d Indara and
owner l conGad Cuyer of tlie aforementionetl property on date applicafbn a filed.
�8^3�^a (R�T'�s hal name) �J �i ` � � Date (mWh, daY. Y��)
adEmss
AdErassdaulhorizedperson (nvn6orandstroof,dty.sbta.andLPmdo)
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