HomeMy WebLinkAboutMortgage_Kramer (16)ry� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ = POR DEDUCTION FROM ASSESSED VALUATION
� State form 43109 (R77 / 6-09)
S f P�esaibed by �epartmefrt of Local Govemme�d Firence
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To 6e filed in person w by mail witA tlre CouniyAuditor or Counry Recorder o/ the county where fhe pioperty is located. D��� �"�
Fi/ing Da[es: 1) Real Property: Must !le dunng Ne year (or which fhe deduction is soughf. "� un Auditor
2J Mobde / Manufadu2d Homes nof assessed as Real Properly MuSt file dunng the fweNe (12) months
6etore March 31 of each year the deducfion is sought. C'�. n ry Remrder
See reverse side for addifional insfructions and qualificafions.
App5cant (D�rar coril2C buyer-� re.V+icti�ns m reu�rse siie) �/
hssrssed rdue af real WapertY a of
MarM i. aurrm yrm
If ro. wluf is 1� ! Mr eYacl
l.�_.�T'�11'-�
se0er
r / legal tlesaiption
/q_o7-3 00 _000
n�a e/ Contract irdehtetlnass unpaid as of
n�a�h�.w�mr� 01(0�0.000
Mdress of mortgagee a contract se0er (numbrl aM stree; crty, state, aM ZIP crode)
Name of assignre w o�er rnmer or holAer of martgage
RecorE number Page rwmba
o �.s a
Cmvad irMebtetlness unpaid as o is Ne appfirant ihe sde
�frcation �gal w e�itae�e owre/?
� Ye5 ❑ No
D��a����C�- \�0....�i.,......
[-F/.1/ Cal'd �`O. ....S,oa,1......
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Ad7ress of (numbei aritl stree4 �1: state. antl LY catle) /Q .�/� � G'
� s� �-3 - o
Does epplifant own property in any dher If yes, whal munt�/1 What Ta�drg Distrid? Nas Nis Oetlurlion Eeen reQUested on property
munry in IMana? ❑ Yes ❑ No tw wrrent Ye� ❑ Ye5 ❑ No