HomeMy WebLinkAboutMortgage_Yancey"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n T wnshi Year
,_, : FOR DEDUCTION FROM ASSESSED VALUATION
• Stata Fam 43709 (R11 / 6-09) �
S,.» f ��e br o��H a� co��m F��
File Mark
INSTRUCTIONS: AU
To be filed in rson w b mail with fhe Coun Auditor o� Coun Rewrder of Ne coun where the ro F �
Pe Y �Y �Y ry P PehY is located.
Fifrrg Dafes: 1) Real PropeAy: Must fife durirg the year for which fhe deduction is sought. � Counry Auditw
2) Mobile / Manufactured Homes rat assessed as Real Pmperty Must file dunng the hvelve (72) months� � r,-1 f! - nry Recorder
befora Mamh 37 of each year the deduction is sought L`1'�`�w
See 2versa side foraddi6onal insfructbns and quali�cations. ... GIBSON C i i
t(owrerorcantraCbu�ye�r//�ee resMcborttmre�e/rsg/ side) /}
NI t_i � Y/1. � dS .� C/1 iri/�LC�� CiC . �Q/Y�.t�
f venie ot � pfopem/
anent yrar
I( iq. wh8t 6 hR / 1re! P�fHC ShNE OI V11¢�CSI?
iber / legal Ersaiption � Remrd numbc Page numCer
- 8-�oD-OdD, o -o 009 3/00
Mortgage / Contracl indebtedness unpaid az of MoRgage / ConVari mdebtetlness unpaid as d Is the appOrant the sde
Mart�h 1, wrrent year date of appGratan legal w epuitade oxnM
�s�, �� � ❑ Yes ❑ No
If name m remN a EiltrJS�t Nan fhat ot appOcant, rtMicate Ceb'vf
Name of mortgagee
Address ot rtartqagee or
•TJ
Oces applinnt own property in afry oNer
munryinlMiana? ❑ Y05
Deductian apyov�-0 In Ihe artqunt of.
�mtgage
stale, antl LP catle)
u y�. what
No
20 _ I 20 _ 20
sqrawreorco�Nnwxo� A /
u
Person
2�
If awned wiN someane aiher than spouse.
Is iM property in Vurstiw�: Mnua➢Y Pssessed
�ft�i a�oaenr ❑ a,��nyw�d
DC1\YCI' ��. ����.........
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A�o� ����-� �o. ....31�:0..........�
Counry
.� �sa, ��
o� ��ro�un. aar, r��
m prapaty
❑ No
�o
certify u r ihe penalry f perj�that e above and foregoing intortnation is W e and cortect ard that the applirant is a resident of trWWiana ard
I con buyer e a me perty on date applicatlon is filed.
(ox+ieh name . Date (rnwvh. AaY. Y��
�nt ol appfcant ( mber a [, ciry, sYdte, alM Z1P ootle)
/ /v S' o,� ��-d� ��a �. -�'_�l Y
NwrizeC by duty exewted Power of AtlomeY � M IC 61.1-12-0.7 DatE (md�N, daY. Y��
f aWmrtrEO person (numberantl sbeel, tity, sfate. entl LPmtle) .