HomeMy WebLinkAboutMortgage_Douglas (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Town hip Year ,�/
_ + FOR DEDUCTION FROM ASSESSED VALUATION 'l�
• State Fwm 43709 (R71 / 6-09)
, � PresriibeO by Oepartme��ri af Lod Gv+emmeM Firance
File Mark
�NSrRUCnoNS: rC B
To be filed in person oi by mail with Ihe CountyAuditor or County Recorder of the county where the property is Iocat6dF-
Fdirg Dates: 1) Real PropeAy: Must file durirg the year for wfiich the deduction is sought.
2) Afo6Be / Manufactured Homes rat assessed as Real Property: Must file during the hvelve [12) mont t� .7
befoie March 37 of each year the deduction is sought.
See reverse side /oradditional instmUions and qualifiwtions. _._��u �
M^a�sed raNe dreal P�aPer:Y as of
Mad� i. aamJa yrar
what is his / her exaG share of
tt rartie m recortl is CtRermt tlan
rtiortga7ee a mnvarl seller
contraa seAer
�-oo-u
ge / CantraU u
�, 9Y�e�� Y�
atsignee «otlml wmer w ndder ot mongage
- D a. 31 �
nrss unpaid as U Mortgage I G
date ol appGc
�
. If awned vriN someorie
Retotd numEer
Ob
bteAness impaitl as d
50a+u. iMicate with wha
County Auditor
�unty Recwder
Page numDrj
iRatle axneR
Yes ❑ No
Is tlre V�P�`/ in CuesErn: MnueDy A.seSSeE
❑ Real Roperty ❑ ArmuallyAssessed
Mobile Hort�e (IC 6
lwy2� pUlaG1.A.5, iJ0/�iilfy /Y� .
cdy, ste:e. a
/JA ✓s0
PAdress of assignee (numbe� arM sUee4 mY. �fe. entl ZIP cotle) �� � 6 —a 4� /
Does eppl'xant own G�P�Y in anY dher I( yes. what ca ian been reGUnsteE on praperty I
munryinlMena? n Yes n No
❑ Yes ❑ No