HomeMy WebLinkAboutMortgage_Wright"'� STATEMENT OF MORTGAGE OR CONTRACT INDE��kjN 0� 10 7ownship I vear
_ � FOR DEDUCTION FROM ASSESSED VALUATION �� �
� � � � Stala Fo�m 03709 (R71/6-09)
�' � Presaibed 6y Oepartmenl of Local Govemmenl Frence
_. _ r ;__ ,•�• � ^ ' File Mark
INSTRUCTIONS: 6UDZ U S �1�Q
To 6e filed �in person or by mail with the CountyAUdito� or Counry Recolder o! [he counry where the pioperty is located. Form med wi�h:
FiNrg Dates: 1 J Real Property: Must file dunrn� the yrear /o` which the deduction is sought �T """111��� �C 1 Counry Auditor
2) Mo6ile / Manufactured Nomes not assessed as Real Pmperfy Must fife nn h�e (12J o�s f-°
6e(ore Mamh 31 0l each year the deduction is sought ❑ Counry Recorder
See reverse side /w addiUOnaf insVUCtions and qualificat6ons.
ADO�xant Oowner m contrad buyxr - see mir�96wu m re�.rrse siie� � ' '
rwmGv
ts his / her exaU share of in�erest?
tt nartre on 2md'¢ diReRnt than that of aPP�^L inEin[e bebw:
Name of rtprtgagea or mntract se0er
rtiart9a9ee u mntraci
w othu owner or hdder of mMgage
sbm,
0
It owned wiN someOne
�I
�� •'
legal or eQUitade wmeY.�
❑ Yes ❑ No
ihan spouse, iMkate wtth wham
Is the property in Vuestim: MnuaM Assessed
�teal Pmpertv ❑ asnualyassessea
.DI':115'CI- �'Q...�'„� 9.
. .J ......
Mtlress of assignee (number aM slree4 �Y, sfate. antl ZIP cade) Ca I' �!\� O. /(,{� ��
� .... h ,
Oaes e itant own property in any oNer If yrs. what munl7/.� VJhat lanrn� w,.,r. 1 O{• ,J 1 3 L �eM1y
caunry m Ind'vna? tar arte�n y�..
n Yes n No I LJ res -.� No