HomeMy WebLinkAboutMortgage_Whisenant"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun wn ' Year
___,. ; FOR DEDUCTION FROM ASSESSED VALUATION
� State Form 43709 (R11 / 609)
S,,,. � Presaibed by OepartrtieN of Larel GovemmeM Frenca
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�NSTRUCTIONS: �E
fo 6a lled in person or by mail with the CountyAudifor or Co�nry Recorder of the county where the property is located. F� ���
Fdirg Dates: 7) Real Properry: Must fde during the year /or which the deduction is sought. "�� Audrtor
2) Mobile / Manufactured Homes rwt assessed as Real Property: Must file dunng the M1veNe (12) months
6efore March 31 of each year the deduction is sought G IBSO C� 7 u ecorder
See reverse�it/e /or additional insfructions arM qualificatiPns.
Appbcant .mer�mnfrdUtyryer-see m2ve+se ' ) / //
wssusea vaWe c±real pmpeny a a
A/aN� i. aarent yrdr
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If no, what a ha / her exafY share o( inU
If name m remd is diRerent Nan Nat c
Nartre ot rtnrtgagee or rvno-aU seller
AAtlress ot rtwrtgagee a cantraa uAer
_ oa�
AbRga9e / Contraa iMebtedness unpaid as o( Mortgage I Contra
Ma`d� 1. wrtmt yrar date of appfifatian
Name ot assignre or dM1 owner w tmlder ot rtprtgage
ACCress o( assgnee (number aritl sVee4 �1: stare.
crty, sfafe.
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aG �s s3
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I 5§�aunr U .__._.
If awned with wmew�e
c.r.i n: � ri_� �t.v t.T:�
20 _ i Zo _
numEu
unpxid as M Is Ne app6rant the sde
legal a epuiiade ovme!!
❑ Yes ❑ No
Mvte vrtlh wMrn
property in queSCOn: MnU20y 0.ssesse�
ral RoPertY ❑ Mnualy Assessed
yean
2�
;iea o� mocenr
ves ❑ No
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Date (rtnNh. CaY. Yea�
I/ We cerufy under the penalry of peryury Nai Ne above and (oregoing in(ortnaUOn is true and correct arW tha[ Ne appli�ant is a resident of IrWiara and
owner I contracl buyer of the aforementbned pro0erty on date application is filed.
� re(owne/s hAname� / V! l /`�-1� Date (nwYh. tlaY. Y'�e�
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FW resident addresY of applicant (number and sheet slate, antl Z/P m
243 �16h�S�n %�VE. ��� r7C2,�
Person au0n�¢eE Dy Cuty ezearcetl Power of AROmey rn by IC bi.t-12-0.7
person (number aritl stree( dry, state, antl ZIP oode)
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