HomeMy WebLinkAboutMortgage_Davis (7)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ • FOR DEDUCTION FROM ASSESSED VALUATION
• SFate Fortn 43709 (R71 / 6-09)
�' � Presaibed by Depariment ol Lad Govemrtrenl Fnance
Fil
IN57RUCTIONS: '��{�l� � • .
To 6e filed in person oi by mail with tAe CountyAUditor w Counry Recorder o/ the county where Ihe properry is k�atetl. F«m m
Filing Dates: i) Real Property Must fde during [he yrear tw which the deducfbn is soughL 1 Counry Auditor
2) Mo6Be / Manufactured Homes not assessed as Real Property Must fiie dunng fhe twelve (f 2) months n
6efore March 31 0! each year the deduction is soughL O� �y..� ��Y Recorder
e ✓
See reverse side (or addHional insVUCtions and qualil/cations �
m
-see miaverseside)
Key Oer/kgald�aip'
f Mortqage/Cantraa'v
Mard� t, wtRnt year
m, what "a his / tcer e�aU share of interesi?
tl nartie an remd is tliRern�t Ihan that ol app6rant, indiote Delow.
a mntraU
rtiorlgagee n
Name M assignee or oNU owner rn holder of mortgage
_OOV. 33 �- 0�/G'q"'"a�o oQl
unpaid as at Mortgage I Contracl @WeMedness unpaid as o! Is Ne e
Oate of aDpGCatig� „ kgal w
fity. sfate. ard ZIP code)
AdEreSS of assignee (number antl streeL WY: �[e. and Z/P tode)
Does e�imnt wm property in any oNer
cou�LLy in Intlaria7 r-i _ .
xneorre ottter ihan spouse.
Is Ne i
R�
-- J _
Yes L� No
prJty in QuesUOn: Mnually Assrs5e0
PropeAY QMnualyAssessed
_. Modle Fimie QC 6
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tar amen� Y��! r-i . r-i .