HomeMy WebLinkAboutMortgage_Emerson (4)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION � �
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` � rresfriceanyoepartmen�aLoralcwen,n»ritFinan�e . �
wsrnucnoNS: f�LM�` 2009
To 6e filed in person or by med witlr the CauntyAuditol d Ure county wheie the poperty is Iocate0.
tilirg Dates: iJ Real Propeffy: Must fde dunng fhe yet+r /or whirh the deduction is sought.
2) Mo6de / Manufacturetl Homes not assessed as Real PropeRy: Must file durirg fhe tweNe (12) mmfhs 6e(ae Mash 310/ eacA year
the deduction is sought. j�(a ��s.�,
Seereve.sesoetoradddiona�inshudionsandqualificatims oIB50N C� TY A DIT
npp4cam (o.nerm q1yor- me msbiQiani m reverse ) ♦
�.�d,���,�,�
aU 1. amartl yea
rw, whal s his / her eutl shara oF ilrteresY!
�ume m recatl ¢ d�eia`rt Uan Ihal o( appl
yne d rrotumee or mntrad se0er n .
�%mG�� Remrd n�mber Pape number
-� -a 3 -� / . 9 �8 -
/ Cmtrad idebtedne� �Mad as U Mortgape / Cordrad indeMeMess un7aid as d Is lhe aPO�N Ne sde
vrtern year dale of appfimtion Ieqal a equRable wne!!
❑ Yes ❑ No
H wmed with saneone olher ttwn sPase. indicate wilh Wwm
�ebr. !s tha MoVaM in Cuestim: AnnuaM Assessad
Pfaparry' Q Mnualynssessed
' -� Modle Hpne (IC 61J-i
nda� or �,one� «�aa �o« ���,ee� a�d �t �: �s�e zm ��
(l
Name d assigrree or oiher awnar a holder d mMpape
oae^ aGM��t awn propeny m ary atrer
mumy in �nd'are1
❑ Yes ❑ Na
/ _ C` ,1 —,
Dedwlion zCWweE in Na amouM of:
COUNTY AUDITOR
20 20 20 20
Sanatura d Caumy Auditar Camly
I/ We certify urWer the penalty of per"ryry Nat the above ana foregdng infortnatan
owner / conVact buyer of the aforementionetl property on date apptiration is filed. � • O"�/,�
Dl'II\�'CC \�...QCIJ+�• ....•...
Card �O. ....�I.�.1P........
jy�w� � � I i o7V. �j
smd� � u,� ma�a�, o�, rev��me «, v�m
for wrranl yea(7 ❑ n
❑ Yes
20 20 20
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d appikam (numbrl antl sboof. r�ly, sbfe. end ZIP code)
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