HomeMy WebLinkAboutMortgage_Keneipp^'ra STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
� FOR DEDUCTION FROM ASSESSED VALUATION
' State Fortn 43709 (R71 / 6-09) � � g , �
�' ,,,, 1 P�esafDetl 6y DePaRmeM of Laal Goremment Fnarce fj
��� File Mark
INSTRUCTIONS:
To be fi(ed in person w by maD wdh the CourtryAuditor or Counry RewNer o/ the county wtiere �heiprope"`(y is`located. Form Aed wiw:
Filug Dates: 1 J Real Property: Must file durirg the year hr which the deducUon is soughG �� � " ' nty Aud'rtnr
2J Mo6�7e / Manufactured Homes not assessed as Real Properly Must fi!e during-the.hveHe.(12J months
befae March 31 ofeach yearthe deduction is sought. � �- � ��"�°"�-`--� ❑ County Recorder
See reverse side for addrtiong�.ti}stnrcLOns arM qualifications . v V
i 'rt ' Keyfwmber/k9 d�smp! /
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e,r�a,eor, ,ro�em, r.w�ge,c,a,v �aee�ea
Marc3� 7. aemnt Ye'ar Mafch 7, arte
� D
rc ro, what Is his / her e�ct shara ot interesn
Ii name on rnmd'6 GiRemnt U�an Nat ol app6qnt bd'vate bebw.
Nama of mortgagee ar mntracl seller ��
Address of mortga9ee or mntreG seller (nurtiher aM shaeL city., , and ZIP
Name a( assignee or othu owner or holder ot mortgage
PACress of assignee (numberaM streef, dy, slafe, artl LP totle)
Rem�d number Page numbu
38�Od1 i9s a a'�S
unpaid as ot Martgage / Corura�3 irWehtedness unpaid as o( Is Ne appfi�ani Ne sola
date of avP�m� legal w equlta6le ovm�7
� ❑ Yes ❑ No
someone oNer than spouse, ind'rcale with whom
Is ihe pmperry in Quesfim: MnuaDy Assessed
❑ Real ProPertY � �u�ally ASSe55ed
Oces ePW�t avm praperty in any oNer I If yes, what munl�/1 I What Taring �isGicl7 I Has Nis EMueban Cren requested m Propejty
munryinlrW"�ana? n., n.. ro�a��,encv�� n., I"1 �
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