HomeMy WebLinkAboutMortgage_Neidigh'°+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_,_ FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm 43709 (R71 / 6-09) . �
�' ,�,� � PresaiOeE by �epartrt�eN of Lod GwemnreN Firta�e
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INSTRUCTIONS:
To 6e filed in person w by mail wiM the CountyAuditor or Counry Recorder o/ tAe oounry where Mm poperty is located.
Fifig Dates: 1) Real Proparty: Must file during fhe year fw which fhe deduction is mught.
2) Mobde / Manufactured Hortres rat assessed as Real Properly: Must Ae dunng the M1veHe (12) months
6efore March 31 oteach year the deduction is mught.
See reverse siQe for addifmnal insvuclions a� qualificafions.
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TaAng Distria
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tt m, what's his / trer eYad share of u
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1, arteM yem date of app�otian
ES
(number end sfine; cy: s�te. eM LP code)
oNU awner a holder W mortgage
Adtlress o/ assynee (num6er aM stree; city; sfete.
Does eppikant rnm property in any olher
munty i� �ndana? fl ..__
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I I We cerofy ulWer the penatty M perjury Nat Ne above and foregoing infortnalion is t.� _
owner I wntrad buyer of the aforementioned property on date apDlication is filed.
I (own fu0�) ' �-'�
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e rowermnnd„ar «M ic ��.i-iz�.�
Address ot auCwraed persm (numDer ari0 sbeet
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ad r
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Counry Audimr
epuitaNe owreY�
] Yes ❑ No
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