HomeMy WebLinkAboutMortgage_Stallings"•'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun s' vear
_. • FOR DEDUCTION FROM ASSESSED VALUATION
� ' ' Slata Fortn 93709 (R1116-09)
��«. Presaibetl y' OepartrneN of LoW GovemrtreM Firenca
F,���INSTRUCTIONS:
To be filed in person w by mail with the CountyAuditw or Counry Rem�der o/ the county wFiere the property is located. FO� �� �' �U
Fii'mg Dates: 7J Real Pmperty: Must file durirg the year tor which tha deductan is sought Coun Auditw
2) Mobde / Manuladu2M Homes not assessed as Real Prt�perly Musf file dunng the fwelve (12J months ��'�.. �ry �
6etae March 31 ot each year the deduction is sought GIB OhQ �o� " Cf �
C:
See reverse side for additional instn�Uions and qualfications. V���
AppGtany(pwner, v convact buyHr - see �p�SnicDOns m re.e�se sjpe)/ _ .
I vdYie cF 2al p�opaly
anPfrt yPar
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rwmber/legaldesaipbon
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Mortgage / Contraa u
Mart�h 1. turtent yesr
It nane m�emd'a QAferent Uun ihai af appOtant, cMirate Eelmr.
Name ot mortgagea or contraa seYu
Pddress ot rnart)agce a contract seAer (number and stree; ciry, staM, and e
Name at assignea w Nhu owner ar hdder of nwrtgage �
AdGress ot asvgnea (number aM atreet �+1: slete, aM Z/P oode) �,
Does epp6mnt rnm property in eny other If yes. what munq?
countyinlMana? ❑ Ye5
❑ No
Deductim appm+ed in tlre amount aE
zo
sgr�n,re or co�,n nwnw
zo � zo _
Fm
�b �a�O - Q / � p�0/O
unG�d az of Mongage / CanYact "umtlebcedrress �mG� a d Is
aaee a avarzaum /� oU � �
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What Ta�drg Datr'rY?
4UDROR
I I We cert'rfy u�er Ne penalty of perjury Nat �he above and foregning intortnalior,
owner I mntrad buyer of Ne aforementioned property on date applicatlon is filed.
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J u0 ' ent addtxss W
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sfate,
Pelsan auNorisE �y tluty ezecuteE Power a(Attomey or Dy IG 61.1-12-0.]
PCCress of aWiartred person (num6era� strae; riry, Ydte. and Z!P code)
r� u No
Is ttce O�P�Y in 7urstian: MnuaAy Asesxd
❑ Real Pmperry Q lvmually Assessed
bbble Hortie (IC 6
9 o.s
Has ih's aedud'mn Daen 29uesteE m properry
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