HomeMy WebLinkAboutMortgage_Bales�
"`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C �}i i, ar
FOR DEDUCTION FROM ASSESSED VALUATION
StataForm43709(R10111-08) AY 2 S 200
� � Ptesrribed Ey DapnM�enl of Laral Govemmartl Firenm
�NSrRUCnoNS FIe Maric
To be filed in person or 6y med with Ure CouNyAWifor d the county where fhe poperty is located. ry�., �
F7ing Da1es: 1J Real Property: Must Poe tluring Ne year7or whfich fhe deduction is sd�ght. I
2) MobHe/Manulactured Homes nof assessed es Real Properly: Must file tlunng tl�e tweNe (f2J monl�����d��/ r�
the deduction is souyhl.
See ieverse side (m edd'Aional insWdions erM 4uali(cations
Afarch 1. amard yaa
C ro, whal's ha / her eratl shara d iNerest9
C �ame m record is d'dlerenl Ihan Ihal of appl
Narre d mortgagea or mvred se�er
i
Atltlrass d mongagee or conlrad se0er (nuru
� �— U�v,
Mor�p e/ Cp�irad'cde6tedness unpaiE as of
Mardi.7. arteN year
N O�mi
wtl. irdimfe bebrl
Name of ass5nea w oihar wrtre� a holder d moM19aBe
��s a ��� ��,�� � � � �m. � � �,
Doas appiicant own poparty in arry ol
muMy in Ind'q(v?
❑ Yes
DeCUCtion approved in 1he artqum of:
ZO
Signalure of Coumy AuEH«
20_ � 20_
couNn nuorrc
20
�pape � i:ormaa moeceeaness unFan as m is ma appram Ine mla
r of appfimtion /� legal ar eQUEaGIa owne/!
//p�. QOO ❑ Yes ❑ No
someorre olher Uun s0u+se.'ud'Kate wiQ� w}nn
b �he wwaM � vuaslion: av�woy wssassed
� Real Pfoparty Q MnualyASSesseO
, � ���� ��' G
3p�, �p� 3
0����3
20 � 20
'GartY
� No
I l We certiy urMer the penaity of perjury that the above and foregoing mfam�ation is W e anE cwred and that the applirant is a resitlent af InEia� anC
oyq�er f mntrad buyer of Ihe aforementione0 propeRy on tlate applitation is filed.
^J
��
l�J,
Data (maYh. tlaY• Ya�
_ /'