HomeMy WebLinkAboutMortgage_Hersel"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co own i t
:_. FOR DEDUCTION FROM ASSESSED VALUATION
� � Sta[e Fwm 43709 (R11 / 6-09)
S,,,, P�esaiEetl M ceP��rd ot LnW Govemmera Fuwm
wsrRUCnoNS:
F E9�e 8'�
To be ned in person or by maii with Ihe Coun Auditor w Coun Reoorder of the coun where the F� �� ��
h N ry Woperry is located.
FiNng Dates: 1) Real Property: Must fde dunrg the yrear /or which the deducfion is sought. � di�
2) Mob�7e / Manulactured Homes not assessed as Real Property: Musf file dun the fwelve (72) months
6efore March 31 0/ each year the deductiWn is � /
sought. GIBS N Nri�' `
See reversa side for edtlifronel inshuctbns and qualificatrons.
MP��I (owrierar mntrac� b✓Y�' see ra�r=o^s 9^ ���i �e) _
As�s5e0 ralue dreal P�D�Y %s �
Me�d� 1. am+rt yPar
n �o. wn�c a na i n« e.aa sn�re
a^i
mortgagee Or mntrerl seUer
icer rce�n« i �a� eesa�pn� .
- -07-/o3-Oa.
ge/ Contraa We6tedness unpaitl az d
1, currem yPar
contraa seAer (nunber end sbee4 r�: smm, arN
of assignea w othP1 Ownel or halder of mort8a9e
(wmDa� eM saeeL mY• stete.
Ooes epplipnt o,m poperty
munryinlndana? r
��11
.$78-03-8 �
Matgage I Cantras uWebtedness
Eate ot appGCation
Disbict?
�.
Rem�d numDer Page wmbrl
O S
unpaiE as d Is Ne eppGr�ant the sole
kgal w epuita6le owneYi
❑ Yes ❑ No
Is Cce WopertY in Questim: Mnua�y Assessetl
❑ Real ProPeri' ❑ Mnua�Y Psse55ed
W.
Has Inis Eedudim Eeen reGUested m propaty
for artent yeaR 1-'1 .,_ _ 1"1 �