HomeMy WebLinkAboutMortgage_Sellers (2)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
• Stata Fortn a3709 (R71 / 6-09)
�.,,, f Presaibed M Departmen� of Iocal Governme�ri Fu�artb
wsrnucnoNS:
To be fiied in person w by mail with the County Auditw or Counry Recorder o/ the county wheie the pioperty is located.
FiNng Dates: 7) Real Pmperty: Must file dufig the year for which fhe detluction is sought.
2) Mo6de / Manufadumd Homes not assessed as Real Pmperty: Must file d�nrg the fweNe (f 2) months
befora Mamh 31 0/ exA year the dedudion is swght
See reverse side (or addifional insfrucfFons and qualificafions.
Counry Auditor
���/ KeY nm6ei / esa�tion � Rewrtl number Pepa rnm�Ea
-aoo-oo� sa9-o as
�ed vahie d� O�PQM as d Martpage / Contraa 4de6tetlness un0aitl az W Mortgage I Contraft iriEebtedness �npaiC as d Is Na �7�� Ihe sde
1, qmnt year Me�ch 1, artent year data o( appfxation legal p epuilatle owfcR
t�°.-�i ��a�.37 _ _ _ — ❑ Yes ❑ No
If no, what is hs I M ezatl share Of intrJxstt
tl nNne on remN's tliflerent fhan Nat ol appPpn;
�.'�".yd"
Name ot rtprt9agea or mntrxt seuu �/� _
Pddrass oi rnwtgagce v contraa seAer (numbe� erd svaet �y. state. aM ZIP code)
wmer w MIEU d mortgage
if awned wiN samec
DI'II11'CI' ��.....���9�.....
C���d \0.......J.�.SSS.....
� IIPU, �%D,�
AdEress of assi9nea (n r aM sfree( crty, state, entl ZIP wCe)
%�i N /-� 19 -.3 - �o y 3`' �`i- c—
Dces a�nt wm property in any otha I( yes. what munt�/T What Tadng DisvilY7 Has iha deduction Oeen repws� m popeny I
caniy in InO"ena? n Yes n No tor airteM STa(� � Ye5
❑ No