HomeMy WebLinkAboutMortgage_Loechler"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
s FOR DEDUCTION FROM ASSESSED VALUATION
Sta[e Farm 43709 (R71 / 6-W )
� ` Presmbetl M Oepartment of Local GovemmeM Fuance
w.
wsrRUCnoNS: f�e
b be filed in person w by ma7 with the CounryAuditor or Counry Recorder o/ the county whele the property is bca�Y F�L u i�:
FiNng Dates: 1) Real Pmperty: Must hle durirg Na year /or which fhe detluction is sought. � Counry Auditnr
2J Mobde / Manu/actured Homes rrot assessed as Real Pruperty: Must file dunng the fweNe (72) months
6efora March 37 0/ each year Ne deducfion is soughi � Cou�ry Recorder
See reverse side for addifional insmictions arid qualficafions.
AooGraq{owroror contrad b sea reSMryatt m reversa side) C31 � �
I'R?�551
_ _. _..'°._______._
� -la,-a8- �0�-003-�,9Y-o�8 Di o �-oSa
real paputy as d hlortgaBe / Contrari irdebtetlness unPaid as W Morigage / CantraG "uMebtetlness unVaid as d Is Ne appOmnt tlre sde
�r MeRh 1. alrten[ year Cafe of aPP�� �� a M���de o.me(1
7 g p 0 Q ❑ Yes ❑ No
hu eYaa shara ot interesi? If awneE with someorre ahu ihan spouse� 4Mlcate wttn whom
is drttermt lhan that ol appOpni, hWip4 Gebw. Is ihe praperty in pues0on: Mnually hssesu0
C$f�� a�oveM ❑ !�,�;�y! a�a . . .
r�a�e ot �rca�� o� m�o-aa une� ��-�.P�N �
ACdress of mat9a9� ar mnbaG sWer (number e t uA: s�
Name of assignea w dher awner or hdder of mMgage
PdCrass of atigtree (number end s1reeS �Y. s�, antl ZIP cntle)
d'xsnt rnm pmperty in any other I If yes. what countyt
IMana? ❑ Yes ❑ No
Deducern appoved'o� tM atmmt
20 _
$ignature M CmmN AuCitcr
I I We cer0fy�
ovmer / contract buyei
Peison auttmmetl Ey
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�tT�o��; Di•a�ver NOn�(............
Card NO. . a05�
\UDROR •••••• •• ••••..
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20 � 20
20 _ � 20 _
Dem (montn. day, yra�
penalty of perjury tt�t the above and foregdng infortnalion is We and cortect and that Ne appiinnt is a resideM of IfW'gna and
of the afoiementioned properry on date appfication is filed.
d appGmnt (wmber and sbae4 m}: ��e, eM LP aode)
person (numDer arM sbeeL �Y. ��, aM ZIP code)
(rnontn.