HomeMy WebLinkAboutMortgage_Ellerbrook""� STATEMENT OF MORTGAGE OR CONTRACT IN �SS Coun Township Year
.r_ .
FOR DEDUCTION FROM ASSESSED VALUATIO��
� Sfate Form 43709 (R11 / 6-09)
�' ,«. PresvibeE N' DePM�M of Lotal GwemmeM Firurce
File Mark
iNSrRUCnoNS: APR 1 9 2011
To 6e filed in person oi by mail with fhe CountyAtiditor or Counry RecoNer of the county wltere the property is located. F�,,�_�, ��'
Filvg Dates: i) Real Property Must file dwng fhe year /or which the deduction is sough� ��. nl!� "" un Auditnr
2J MobBe / Manu(aCured ibmes not auessed as Real Pro g ry
peRy Must file dunn the months � �unry Recorder
before March 37 of aech year the deduction is sought.
GIBSOMCOUNTY AUDITOR
Sea reverse side for additional instruct6wu erM qualifrcations.
AssesseA vWUe d real WoP�Y as of Abrtqage / Contrati indeb
Marth 1. armrt }mr Mamh 7, arrent yeer�
"�•,�,a`� (�.�,,E ELl.��. L3/�UOK-
n�«��
���� a���-�a�s
Pdd� af n �53� (il� � w
Name af assi�ee w o�nl owner or MWer of mortgage
Ad7ress of assrc,y�ee (number aM aneef, tlry, slate. aM ZIP code)
Does apdion[ o�n property in any oNer If yes. whal munp?
munry m InGana? ❑ Yes
❑ No
3W �( ('/• � `�—V /(J Recortlnum / / Pegel � i �
0
ss unpaid as of Mongage / Contreq mEebteOness unpaid as d Is Ne epp(xant Ne sak
Oate of applifation Iegal or epuitade ovmef?
>Ot`� n Y� n �o
Is IM prapaty in question: MnuaP� Assesse0
� Real PfoPenY ❑ �^^��Y �
Whal Taring OistriG7 Mas 1h¢ deEUaion Eeen repuesteE an propelty
for wirent yea/? ❑ Yes
❑ No
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