HomeMy WebLinkAboutMortgage_Blankenship (2)^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship vear
• FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate Fom 43709 (R71 / 6U9) .
S� � P�esrnbed trJ DeParbnent of Lod GovemmeM Fu�arce
ie
wsrRUCnoNS:
To 6e filed in person or 6y mad with the CountyAUditor or Counry Recorde� o/ the counry where the properfy is located. F � Z0�
Fifirg Dates: 1) Real Property: Must file during the year for which the deduclion is sought. Counry ditor
2) Mobile /Manufactured Hanes irof assessed as Real Property: Must file during fhe hvelve (12) months C.
before March 31 of eacA year the deduction is wughG e��
See reverse side /a addRional inshuctions and qualifications. G�BSON
MP��� (�rRr contraC bu�e�- see msLirlion� reverse side) � �p . � R
�strirl Key�unnbel/legaldrsl`riptidn U
� �c�-iq-sa- i�� � do
I ralua drPal poperty as ot Mortgage/ Contrafi irdehtedness unpaid as of
avrent year March 1, wmnt year
e af moRga9ee or mntract seller
"�Z`�C,(�
AAdr� af mortgagee w mntraG seller (nurri6er an
Name of assignee w othu owner or hdder of rtwrtg
AEdress of asvgtree (numberaM svee4 �+ry. s+ate,
s12e4 dty, sfa�. and LP code)
�
ae I Ca
sameo� oNU ihan spouse,
I numDV 1
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I�
wiM whom
Page numbel
e sale
ovmM
n Na
I�y pmppnvm I
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Card � � � �(�
1.
Dces epplican[ avn pfoperty in any oNer �/-y�� If yes, what munty7 VJhat Ta�d� D'atricl? Has Nia EMurlion Oeen requateC m pro(p-r�ny I
munry m InC'm�a? ❑ Yes 114/IVO tor arreM yeall � Yes R7 No