HomeMy WebLinkAboutMortgage_Kruse (4)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ _ FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R71 / 6-09)
S P Presr+iGetl M�Pa�^�M o1 Loral Governmenl Fnarr.e
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�JSTRUCTlONS: p�
b 6e filed in person w by maii wifh the CounryAUditor or Counry Recorder o( tAe county where the pmperry is bcated. . U y�j �[Q � �
Fil'mg Dafes: 1) Real Property: Must file dunng the year fix which the deduction is soughf. � Counry Auditor
2) Mobde / Manufadured Homes rpt assessed as Real Pruperty Must Ae dunng Me nvefve (12) mon[hs , � ,
6efore Maich 31 of each year the deducfion is sought Rem�du
See reverse side (or addifional inshuctions arM qual'dicafions. G I
Aoorxant(ownerorcbi4actbuyxr-seercsfnr�orVmreverresiie) . �. _ /
L 'IF'�L'
# real PoO�Y as of
Y�
If ro. what Is his / her exad 5Aa2 ol interesi?
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A�r�i� e/ Contraa iMebtedness unPaid az U Morlqage I Conbaa udebtedness unPaid az d Is Me aOP�t Ilre mle
Marrh 9, airreM year date of eppfuation kgal w epuitade wme(.�
Q ❑ Yes ❑ No
H ow�red wiN someone oUer pan spouse. iMicate wiM wMm
If name m �emrtl "s dMrJent Nan thai of aPp�nt, uWifate bebw
Name of rtnrtgagee ar
a mnnaa
or holder of rtnrtgage
ury, sfate. aM ZIP code)
Address M asa9nce (nv�nberard sbee4 �: s+afe, antl ZIP wtle)
/,v S /S- 3-
Dces aDWrcant own G�PenY in anY oNer I( yes. wha
��uy��i�am,a� n .,__ n .,_
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Wha� Ta�d^9 DRtn
COUNTYAUDROR
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tlre property in Guestion: MmiallY Assessed
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Drawer NO�,! �,I �
Card NO. ..'� („`,J,
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� (, 3,400. � iZc�o�
o� ��rn. ear. r��
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I/ We certify ulWer Ne penalry of ury that the a e and foregoing infortnation is We and cortect antl Nat Ne appluant is a resident of I�ia� aM
owner I contraG buyer of Ne entioned property on date application is filed.
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rson aWinaetl Gy dJy exewce0 Powu W AvameY � M IC 6t.t-12-0.7 Date Q+ronih. tlay. yea�
Adtlress d auCm¢etl persan (numDeraritl sbee4 �y, s+ata.