HomeMy WebLinkAboutMortgage_Basinger (2)rySTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear Q�
• FOR DEDUCTION FROM ASSESSED VALUATION
�• Slafe Form 43709IR71 / fr09)
�' ,w, 1 Prevnbea M DePartment af Lncal Govemment Frenca
File Mark
wsrRUCnoNS: SE F m
To be filed in person w by mail wifh the CountyAudiror or Counry Reaorder of the county whe2 fhe propeRy is located.
Filirg Dates: 1) Real Property: Must file during the year fir which the deduction is sought. C � _ Counry AuAitor
2) Mo6ile /ManWactured Homes not assessed as Real Property: Must file dunng the hveNe (12) months ��nry Recorder
before March 31 of each year the deducfion is sought.
See reverse side for addifional instructions antl qualfications.
GIBSON C i AUDITOR
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Name a nrongagee «conaaa
Address of mort�a9ce w mntracl seller (numberaM sbeeL crty, stafe. aM ZIP code)
Name of assicy�ee or other ovmer or hddu ot mwtga5e
MEress ot assegnee (number antl s1reeL �', state, and LP mtle)
as ot I Mongage / ContraG indebteMess
Eate W appikation
rc ow�ed wim swneone wher man
Ooes epplitant own property in eny aNer I I( yes. Mfat countyt I W�at Taang L
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as d Is Ne epp�rsnt the sde
legal w equitade ovmerl
❑ Yes ❑ No
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