HomeMy WebLinkAboutMortgage_Silva"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ FOR DEDUCTION FROM ASSESSED VALUATION
• State Fami G3709 (R71 / 6-09)
S ! Presaibed M�Pa�nl a( Lool Gm�emmeM F�nce
INSTRUCTIONS:
To 6e filed in person or by mail wiM Ihe County Audiror or Counry Recorder o/ fhe counry where Ne pmpetly is locafed.
Filing Dafes: 1) Real Pmperty: Must file during the year for whicA fhe deduction is soughf.
2) Mo6ile /Manulactured Homes rwt assessed as Real Property: Must file dunng [he Rvelve (12) months
before March 37 oJ each year the deduction is sought.
See reversa side (or addilional inshu ' s alM qualifications.
ror U6vyer- re rerersesCe)
C T � �vaitor
❑ County Recorder
� `/�l �1a����''� , ��� : � •
�I.�.,..J- '�' ". '"�.r' ' '
of real Ort�r�' az d
iR ,T1
below
Name of rnutpagee a cmVaG seAer �
Address o1 rtwngagee or mntraa seAer (num6er eM atrae; ciry, sfate. aM i
Name al assignee w o1hr1 owner or hoNer of mMgage
P.dEress oi assignee (num6er and spee4 �: slefe. eM LP catle)
Dces eppli�ant avn propeny in any oNer If yes. what munt}?
munry in IMaria?
❑ Yes ❑ No
Deduction approved in �tre amounl oY.
ZO 20
1 I We c�Nfy under lhe penalry of
owner / mntract buyer of ihe afon
rZ�7
20
� e ,
as of Mortgage I Con� indebtedness unpaiG
��
Pa9�� /
w equttaae rnmert
❑ Yes ❑ No
somearre dner Inan spouse, u�tlwaIe wm wnom
Is iM property in Qurstion: MnuaDy AsesseE
❑ R�i a�naem ❑ nrn+�i w�a
""�" Dra��•erNO.fJ..i.�.`-f.�;z.1
\UDR Cal'(� l�i�. ..........�/,
Ihe above and toregoing informadon
property on date application is filed.
state, antl
Pdtlr� of aut�or'¢ed persan (num6er arM sLee; ciry, state, a� LP code)
ei(I^ �., I Da�e (r+�o�vh. Eay����J �
/ dP 1 n/1 / YI � l
���.J�1l.ci ��
and cortect and that the applirant is a resident of Indiare arM
Date (rtnnlh.