HomeMy WebLinkAboutMortgage_Brown"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
__ _• FOR DEDUCTION FROM ASSESSED VALUATION
Stata Fortn 43709 (R71 / 6-09)
�' �.�. Presaibetl M DeParbf�eM o( Local GovemmeM Fu�arce
INSTRUCTIONS:
To be filed in person a by mail with the CounryAUditor or Counry Recorder o/ the county where the poperty is ocat .
Filing Dates: 1J Real Property: Must file dunng the }rear (of which the deductlon is sought.
2) Mo6de /Manu/actumd Hanes not asscssed as Real Property: Mus! file during the fweNe (12J montf� P R
before Maich 31 0/ eacli yenr the deduction is sought
See reverse side /of additional inswUbns arW qualificafions. _ _ --v„
s�sed rahc d mal pmprny as of
md� 7, c�arent year
ro. what Is his I hrs ezad shara o
name m remrE's C'illerent Nan tl
'�.� �1d'�if f C.Td1? CL�C c
desaipYnn
, a � � ,4�.c��i
�e / Contraci intlebtedn¢s unpaid as d Mon
. arten[ yrar tlate
If ownad wiM :
Name W rt�e� mntract se9er 1
\ 1)l
ACdress W nwrtgagce w contrad se�er �n�mber end street
Name of assignee a oNer ownet u Iddu M mort9age
aea�.s m �� ���� am �c �: ��e, �,e zia
Ooes epplinnt axn property in any olher It yc
munry m �ndgna? n Yes ❑ No
DeOUCtlon app�oued in ihe amount oE
20— � p— � �—
�U �unty Auditor
Counry Remrder
Rewrd num6er Page numbr!
�= i� aoiv i�3o
ag�/� 'viEjebt/eN'�wss �mV� as d �I a� mmeri
�`l Li �/�l n Yes n No
sPouse. 4tlitate WN MTOm
is the property in purstion: Mnu�
❑ Reel P(opertl' ❑ llnnual
A�oble
aMLPCOda) /
- (�►► � rX�c�... (�1(oc.�,-� —
unryt vm �i
�
�o��,A�, �.ao�0
- � �3�
20 _
�
I I We certty uMer 1he penatty of perjury Mat the above arW toregoing intortnat �Q� ��1y��,Q
owner I contract buyer of Ne aforementioned property wi date applicauon is filc �
�nanue(owne/sN➢name) � �Q.
A \
Bnd 2fP oode)
Oy dWy ex¢Wi¢tl Powef W AIIOmCY a q' IG 61.1-12-0.�
red pnl5on (numDCr and 5freet mY. slale. an0 ZIP ootle)
Date (monfi. EaY. Y��
na and