HomeMy WebLinkAboutMortgage_Minkler""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• Shate Fortn 43709 (R71 / 6-09)
,' ` Presai0ed Oy Departme�n of L.ofal GovemmeM Flrence
File Mark
IN57RUCT10NS:
Form filed wiN:
To 6e filed in person w by maii witA the CounryAUditw or Counry Recorder ol the counry where the property is located.
Filirg Dafes: 1) Real Pioparty: Musf file durng fhe year for which the deduction is soughl. � Counry Auditor
2) Mo6Be / Manu/acturnd Homes not assessed as Real Properry: Must file dunng the fweNe (12) rtwnths
before MaicA 31 07 each year the deducLOn is soughi. ❑ �^�Y R��
See reverse side lor additional instructions arM qwlilcations. ��— 5� � 3
��.. ADP�tt'?^i (owner a aontract buyer - see restiirlior}s m reversa sida)
I Taring Oistrit�l
�
6 �15 i �ICf fl(d(']
KeY
airtent
If name m remrtl's dAferent ihan Nat M appGmni, trMirate bebw.
oi mortgagee or contrad se4er
�
� of m rtyapee ar mntrad se0er
or aNU ovmer ar
stafe,
mort�age
slate, antl LP mtle)
number � Page numEPi
unpaid as of Morigage I ContrarY intlebteMess unpaid as d
date a( appGCa[ion
K awnetl wiM swneone oGwJ ihan sCa+�. Ndicate wtth whom
property in Quer,Um: MnuaDyASSessetl
�I Pmperty Q AnnuallyPssessed
No
Does epplimnt own p�operry in eny oNer ,�,^ If yes, what muntyl Whal Te�dfg D¢IriU7 Has Ihis deduGim Eeen requested an pmprlty I
munry in Intlana? ❑ Yes L�1Mo for curtent yeaR � Yes ❑ No