HomeMy WebLinkAboutMortgage_Rish"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS nip vear
__ _; FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm 43709 (R71 / 6-09)
,,.,. PresoiEed by DepaRne�ri of Local Govemmard Fuance �
Fi��
wsrnucno,vs: JUN
Fam Ned wMh:
To 6e lled in person w by mail wiN the CounryAUditor or Counry Recorde� o/ the counry where the property is located.
Fil'ng Dates: 1) Real Property: M�st file during fhe year for which the deduction is sought ��.Cqun Auditor
2J Mobde / ManulaUUred Homes not assessed as Real Property: Must fiie dunng Ne M1veNe (12J mont� O' , ry
befae March 31 0! each year the deduction rs sought ❑A��#temrder
See 2verse side !or additional inswctbns and qualificatrons. GIBSON C � Y
IAppGCarh(T�e�ormvraC6uyer"teeresLi-�orssa+Veverseside) •
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Me� 1, armtrt year
ra, what Is his / her e�d share of interesi?
- � -_3os�- ooa.o59-oa-8
e/ Contract irdebtedness unpaid as U Mortgage / Con�act hWebteM
I ��.QO DOU ���a`�
tt nanx m recp0 b 6t1e2nt lhan tlat d app6rant hiAimle Eebw.
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nnrtgag� or mntracl sWer �numDV s0u streeG �y..ffi�e,
or othu owner or haNer d rtqrtgage
H ovmetl
b Na epp6�t tlfa sda •
kgal a epll@able avrtrYl
❑ Yes ❑ No
than spouse. Indkate with whom __ _
�.SN. �'�'o� K
ao,�,a�as
AEdress of Bsslgnee (num6er antl atrae; dty, Stale, ap� ZIP tode) �
I' 7" 5 /8� d� -/O . 8 S/Q- C -
Dors e�i�ant avm 7�G�Y in arry oNer If yes. what munty7 NTat Tarin9 Distrirll Has Nis CMuctim Geen reGUest�-m qopeny _
�� � ���7 ❑ Yes ❑ No � �� �n ❑ Yes ❑ No