HomeMy WebLinkAboutMortgage_Curl"'3� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun i Y �
_. FOR DEDUCTION FROM ASSESSED VALUATION
• State Farm 43709 (R71 / 609)
�' ,w i p��bed by OeParvnem of Laal Garemment Firurne '
F��e �ev i s zo�2
iNSrnucnoNS:
To be filed in person w by mad with the CountyAUddor o� County Recofder of fhe counry where the propeRy is located. Fam Ae�wict� n` .�,
❑ �'�,M �1
Fili'g Dates: 1) Real Pmperty Must file dufig the year /or which Ne deduc6on is soughG Coun A��r��
2) Mo6ile /Manufadured Homes irot assessed as Real Property. Must fife dunng tAe hvefve (12) monfhs V
6eforaMarch37o/eachyBarthededuclionrssought _ G��I�GQ�I'1tRE4oY�p�T R
See reverse side !w additional instructions arM qualficafions.
Mame m morcpagee «ca,o-act sener
AEdres N nwrt�agce w contrad se0er (n�m8e��
Name ol assi9nee w othei awner or hdder of mwtg
MEmss of assigfree (nurtib�aMstreet �: state,
Ooes aPplimnt ow+i MopertY in eny oNer
counry m Indmna? ❑ Yes
❑ No
�� - �3a�- dUV. .�� .�
�/ Con4ac[ indehtedness unpaH as o( Mortgage I �
airtent Yea� tlate O( aPP�
stree4 �N, sfate, aM
u ovmee wi�
COUNTYAUDROR
^ � �
Record numbrl
��b��
Yes LI No
property in Question: Mnua%ASSCSSed
�I ProPenY ❑ ��Y �
Ihis deduGian been 2Quested on P��Y
urtent yeaR � _ _ �
20_ 2q_ 20_ 20_ /: �.
�.�,�_� r�NA� �..yN;�
sigrenne w Caunb nudi�or ��
I I we certiry under the penalry ot pe�ury that the above aM foregoing ir / 1 �`L �Q
owner I contract 6uyer of the afo2mentimed property on date applicadc °� �`� I
� (omre , 1 e)
�
� F resident adtlreu o/ ap�cant (number antl shee4 tiry, state, and ZIP code)
O�S Oow •z� � I e xN
aers� aw,o�a ny awy ���a r� ornr,omer w ey ic �i.i-i z-0.�
Address W auNwaed pem� (number end sbeef, tiry, sbte, eM LP ootle)
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