HomeMy WebLinkAboutMortgage_Edrington"'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ovmship Year
,. FOR DEDUCTION FROM ASSESSED VALUATION
� Sta[e Fortn G3709 (R71 / fi09)
�' w. Presmbed M�rtmeH af Lnd GoverturmM Fuance ��
il Ma
wsrnucnoNS:
b 6e filed in person w by mail with the CountyAUditor or Counry Recorder o/ the county whera the property is located. F� �� ��
FiHng Dafes: i) Real Propeiry: Must file durirg the year /or which fhe deduction is soughL O C T O�Z�nry Auditnr
2) Mobde / Manu7actured Homes rat assessed as Real Property: Must file dunng the nvelve (72) months ❑
befae Maich 37 of each year the deduction is saght. Counry Recordu
See reverse side (or additional inshuUions and qualifications. ..
ed vahie d� p�perty as d
t. anent yrar
�i M. W�Id� 6 i15 ��IPl EYdC 5�1dI8 Oi IIIiCRSI)
GIBSON
egal �aiplion Recad numbn Page numbrl
-ia-i8-ao3_ooi. �os-oa� �.00� Y88�(
rctga9e/ Contraa irdebteEness unpaitl as U MoRgage / Con:raU uWeMetlnrss unpaid as d Is Ne appit�nt Ne sde
uth 1 wrtent yeer date of appfimtion legal a equiiade a�
�� �, �% n n Yes n No
m fecwd a EiRe`art ihan that of aGP��t trMirate Eelaw.
��� a ��
ray, sbm, ard LP oode)
Name ol "cy. ea w othr! ovmer or holder ot rnorigage
AdCress of auig'ree (number erN stree; ray, slate, aid LP tode)
Oce5 applitlnt ovm prope�ty in any oNer
munry in IMana? � _ _
zo i �
I I We certify under tt/E penalry of
owner I mntrad buyer of the afon
��re co,�,�,�,�mi �--
COUNTY AUDRf
� zo
Couny
peRy in OueStion: Mtwa%AZSessed
PfaPelt�' ❑AMWIIyAssEred
r�oaie r�„e nc ��.
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o, �-����
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J
CI-� IZ��S
� ys, S�o. �,�
Ihe above and (oregoing infortnalion is Vue
proOertY on date application is filed.
%/% /1/. 3l`"�..1�/.� C�zf
auNOirzeE by GWy executed Power o( Attomey w by
person (number a�M sbaet, Uy, stale, aM ZIP ooda)
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�i ��U
Date (rtmfh. Ozy, l�ea�