HomeMy WebLinkAboutMortgage_Spindler (12)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun s' Year
_ s FOR DEDUCTION FROM ASSESSED VALUATION
� � State Fwm 43709 (R71 / 609)
� I p�yyrp�p yy pepy��ent ol Local Govemment Finance
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NSrRUCnoNS:
To 6e filed in person or by mail with the Cowry Auditor or Counry Reaorder of Ne counry whe2 the property is locafed. F� �� ��
Frlirg Dates: 1J Real Property: Must file dufig the yrearlor which the deducfion is sought. ��� ud'rtw
2) MobAe / Manufactured Homes lrot assessed as Real Pruperty Mus! file dunng the tweNe (72) months ❑ �l� ��\
6efore March 31 0l each year the deduction is sought ty� c�der
GIBS �T
See reverse side lor adtlitiunal instniclions arrd qualifirations. ''
App6tar�i(awneioltonbacj.4uyer-5e 5nc8auon2wrsesiy9) • n ..
T �s KeY man V� legal Cesa'Otan �� (U�. / �—(J � Recofd/`u /� Pa9e numbu�
ll v
vaNe of real property as of Mw(pag e/ ContraG "vWe6tedness unpaiO as of MoRgage / Con�aU inEe6te0ness unpaiE as of Is Ihe appaant Me
1. arienl year Mardi 1, artent year date ot apPGntionu �,` legal ar epuitade ovmeYl
3U a � ❑ Yes ❑ No
If rm, what Is his / her euc� :JUre of intuestl . If ovmetl wiN someone oNer tttan spouse, indkate with whom
If �me m remd is EitFerent Nan Nat of aPP��4 h�d'uate bebrr. Is property in Question: MnuaOy Pssessed
Real ProPeKY ❑ Annualhl A�s�
ModleHome C61.1-�
Name W rtnrtBa9ee a mntrarl seller C J /
!
Address ot nnrt�agee w contract seAer (numbrl and �dy, sb1e, aM ZIP code)
Name ot assignee w other owner
Maress ot assi9nee
Oces ePWirenl own �
munn in Intlia�u?
rM shee; dry. slate.
any oNer
Yes ❑ No
iwon approvea m me artwum or.
20 _ 20
3Wre W CAUnNAWitor
� � i-�i� /3a,vc
munty? W�at Tadng DistrictT F1as Nis tletlu�'lim Eeen reQUesteO on praprlty
far arrent Yeaf.+ ❑ Yes ❑ �
COUNTY
2� � 2a _
I I We certify unCer Ne penalry of perjury that the above and foregoing infon
owner I contract buyer of [he aforementioned pmperty on date appliptlon is filetl.
� $Ipnatu�{pwriB(5 0 � )
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X Fu0 �dant d a t(numDerand sbee4 �Y. te, a Z1P ootle) ,' ���
P � L✓ a-cb .$�� %V
Puson auNwrsetl �y didy executeE Power al Attomey w Gy IC G7.1-12-0.7
Pddress ot auihoraed persan (numbere�M sbee; dry, sYdle, end LP code)
Dra��•ei• \'O..°�1�I
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15(,3oD.c�
Date (monfh. daY. Y��
oa� (�,m. aar, r��1
20
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