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"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_ FOR DEDUCTION FROM ASSESSED VALUATION -
� Sfdte Fortn G3709 (R11 / 6-09)
� Presaibetl g' DeParUneM o! Lo�al Gavemme'k Finarice
File Ma
wsrRUCnoNS:
To be filed in person w by mail wdh the CounlyAuditor or Counry Recader of the counry where the property is located.
FiNig Dates: 7) Real Property: Must file during the year /or which the deduction is sought.
2) Mobile / Manufactured Homes not assesced as Real Property: Mus! file dunng the hveNe (72) monMs
6efore March 31 of each year Ne deduclion is saght.
See reverse side tor additiona/ insVUCtions aM qualifications.
Mu��t(owrerorN�+��6`pRr-S4e�^d^"�:,^�m verseSidEl . A . /
County Auditw
T Diyy'v1 Key I legal dewi ' � RemrE numba Page nun0a
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A� vahc d mal papu:y as of AWt��pp / Cmtr�ar2 4d�ness u�0a� as U Mongaga I ContraU uWe6tednes� imD� as d Is Ne aPP�� Na mie
F1ard1 7. anent Y� Mefdl �, avlml y'ar Eate of eppOcation k�l o/ ePNbtle ow�ce�7
❑ Yes ❑ No
If ,� ,�Y/�' 'Aj�— �4 �^ ` V` , ✓.1 with wmeone dhei Man spouse. cdi�ate wiTh whom
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(e pnpeRy in Question: Mrn�a➢Y Atseised
Rea� a�oaeny � nm,�aM�d
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dn9 D'stnG7 I Has Na tleGUmm Deen reGUrsteO m P�P�Y
�w�� ❑ Yes ❑ No
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