HomeMy WebLinkAboutMortgage_Richardson"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 7 i Year
_ � FOR DEDUCTION FROM ASSESSED VALUATION :
• State Fortn C3709 (R71 / 6-09)
�' � Presaibed hy OepartrrieM of Local GovemrtreM France
File Mark
wsrRUCnoNS: Jq
To 6e filed in person or 6y mail with the CountyAUdito� or Counry RecoNer of the county where the p�opeRy is located. F �
FiNrg Dates: 7) Real Pioperty Must file dunng the year (or which the deduction is sought. n County Audhw
2) Mobile / Manufacturcd Homes rMt assessed as Real Pruperty Must file dunng the Rvelve (12) months� �%•��-
befo2 March 31 of each year the deduclion is soughG 'Cj"� ��unty Recorder
See reverse side 7a addRionaf insLUCtions arM quali�catbns. GIBSON C
Ap�ant (o� � contrdrf buyE� reshir�orss m reverse sitle) %
o�som
Ac�sed �ralue oF real PmPertY az
Ala�ch 1. ar�errt year
iw.
name an remd is difterent than
�� m ��� «�,v� �ne�
ACdrea ol mor�gs «wnbaG sWer
ar athu awner or
Ooes ePplioN own property in any oNe
counry�nlnEana? ❑ Yes
DeCUCtian aCW� in the amount
20 _ � 20
SignaWre N Counb Auditor
I/ We ceNfy under�e penalry
owner I contract buyer of the a1
X Si9nawre(ownaf:lutl me)
(.t,�: a
FWI resitlent W appfrcan[ (nvi
u n� n� v �.,� �c�
ier I legal desapiptian
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Mortgage I Contraa iritlel
Mamh1 artentyear
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r�; ffite,
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RemN munbu
3. al _o a. o0
as d �MOrt9 �9 P/� �'uMebtedrress unpaW as o( i
someone
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aoo �- Co.3o �
Power af Httorney or by IC 61.142-0]
Adtlress ot aufl� person (numberarM sbeef, tiry, state, and
Page number
Y� u No
Mnuaq Asessed
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