HomeMy WebLinkAboutMortgage_Piper"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co n;I j To�✓nsPiip Year
__ � FOR DEDUCTION FROM ASSESSED VALUATION � ;i�
• . •� '• State Fwm 43709 (R11 / 6-09) �LJ
S,.0 ! Presaibetl by DeparVrenl of Laal Govemment France
wsraucnoNS: NOV 6'��3^'�(jQ9
Form filed wifh:
To be filed in person or by mad wiN �he CountyAuditw or Counry Rern�de� oJ fhe county where the poperty is bcated.
Fitirg Dates: 1) Real Property Must fite dunng the year lor which the deduction is sought ( a'�,C�,nunry Auditw
2) Mobile / Manu/acfured Homes not assessed as Real Property Must file dunng Ihe hvefve (12) monMs O❑ /BJ�'nN�
6ehre Ma�ch 37 0/ each year the deduction is sought.
GIBSON Uh� f AU��7DR�ef
See reversa side 7or additronal inshuctions and qvalifications.
t(owner or mntad buyer� see m re�erse sile�
Assesse0 rW�rt o( eeal P�W�`/ ��
Ma�G� 1. a+�art yrar
I( ro. what a his I her rsar2 share ol u
It name on temd is ditfe�ent than tha'
�����a�,���
Key rwm0er/lepal Eesaiption Remrtf number Page numOrl
�-� - 3 - yoa -000. 6 �-� - o �. � �.o0 9 s� � �
1A��� ge / Convarl intle6tednass unpaid as of Mortgaga / ConSaa'uMe6teMess unpaiE as of Is ihe apptirant Ne sde
Mam3� 1. n�rtent yeer date of eppGcation kgal a epuilable owneY?
79 n n c� ❑ Yes ❑ No
Address of rtartgagee w mnbatl se�er
Name at assignee w oNel ovmer wldder of matgaga
Atltlress ot assig�ree (num0er entl sfreef, rdy, state,
� s. �s -
cdy, sbte, aM LP code)
srniieone oLiu V�an spouse.
in Question: MnuaOyAssessN
D,-�,���►� �to.... a.oC?`�.....
Card \'O. ....-�.�.I.�.��
.� � 1� � W�+' � Vv
Dces applimnt avm property in arry oNer I( yes. what munp? W�al Tari(g DistriU? Has Ihc deduCion Eeen reQUesfed m p(oputy I
munty in lntliana? ❑ Yes ❑ No . br amriu YraY' ❑ Yes
❑ No