HomeMy WebLinkAboutMortgage_Hoover (5)"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownshi vear
_. FOR DEDUCTION FROM ASSESSED VALUATION ' �
Sfate Form 43709 (Rt1 / 609)
S�w � Presrn'EeE by Departrtierrt af La�al GbvemmeM Fitwtce
File Mark
INSTRUCTIONS:
Fortn
To be filed in person a by mail with fhe CountyAuditw w Counry Recorder o! the counry where the property is IocateDdE �
Fitirg Dates: i) Real Property Must file durng the year for whirh the deduction is sought. ' ��Counry Auditw
2) Mo6de / MarufaUured Homes not assessed as Real Prtiperty: Must file dunrg Ne tweMe (12) monM�j �7�"
befora March 37 0! eacA year the deduclion is saght �"r 6 ��+7�/. Caunry Rewr�der
V
See reverse side /oradditional inshuctlons arM qualificalons. GI090N COU
Ap townerwcontractDuyxr-seemSricDOns,qnmrersesitle) �. ,�.
��� � �o'�/d-D - Dl-OD3. �3-O �� 2�DIV P�S�r
�sed rahm d real poperty as ot Mortpag e/ ContraG indebtetlness unOaiO az of Mortgaga I CantrafY mdeMNriess �m7aid as d Is the eOD�t tlx sde
eRh 1. amnt Y� Mamh 7� rtent year aate ot eOP� legal «eQWta61e oxneR
❑ Yes ❑ No
ro. whal is h¢ I t� eraU sAare Of intemstl H arrred vnih � oCrer Ihan spouse. IMrate Wth whom
name on �emd'n Qtlfurnt Nan ihac W eppOra�4 hM'wate bebw. h Ne D�PP+N in Qu�tim: MwaMl�essed
� Reel PfoPeKY ❑ M^uall�'A�s�s�
0.bdle Hortie C 67.1-;
ama of mortqagea m m�trarl se0er �/�
Address ot nnrtga9ee a mntraa seAer
Name d a4ignee m Ww1 ovmu w Imldel af rtqrtgage
nearess
omuaio� aoo�c m me ama,�u a
car. smre.
cdy, smte, erM LP rode)
COUNTY
�_ � p— � p— � 20
Sig�aMeo(CambAudimr __ /
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I I e cerGfy un� r Ne penalry ot
owner I contract buyer of the
Sip (owne/s I )
Fu0 ' ntaOAmssde t( a
1509 c,v
Pgson autlnraetl �y duy rxecuted Power �
AEdress of auNorrzeA D� (numDeleM
N 78
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r« amvv yea�' ❑ ves ❑ i
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Dra���cr NO.. °f 010 _
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CoumY C.11'(� 1\i�: ... �� J.l........
� i 94, 387 °°
that Ne aDOVe and toregoing infamatiwi is we and cortec[ ar�d ihat the applinnt is a resiaem o� �nuw� n...M
�ned property on date apPlicabon is filed.
Date (monfi. daY. yearl
Sfree4 �;
�y, sble. erE Z!P cotle)
(monN. daY Y��
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