HomeMy WebLinkAboutMortgage_Gibson (4)^�� STATEMENT OF MORTGAGE OR CONTRACT INDF
_�� .� FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate Fwm 43709 (R71 / 6-09)
S,,,, 1 Pres�nbed M DeP�reM of Lo�al Govemtrrent Fraxe
Coun . Tovinship Year
File Mark
INSTRUCTIONS: F� m� ��:
To be filed in person w by maB with the CounryAUditor or Counry Recorder o/ the oounty where the pioperty is located.
F�'ag Dates: 1) Real PropeRy: Must fife dumg the year Por which the deduction is mughL � County Audiinr
2J Mobde /Manufaclured Homes rrot assessed as Real Pmperty: Must fi!e dunng the M1velve (12) rtanths � Counry Recofder
before Mamh 31 01 each year the deduUion is sought.
See reverse side 7or additional instrucUons end qual'fications.
�
no, what Is his / her esart share of interest?
narn¢ cn rem�d is N.Rerent Nan Nat of appGranl,
Name of mortqagee or mnvaa
Pddres
:so3 � u� . a �r a �
�e / Contract 4Mehtedness unpaid as of
seDer (nuniber aM sbee{ ci(y, sla�.
othel mmu or holder M mortgage
ard shee; dry, state, eM LP
'�.r�"L-�%i
: un0aitl as of is the aPPtirant ihe sde
legal or equllable ovmell
❑ Yes ❑ No
rtM'x'ate wltli wtwm
Is the property in 9��: �nuelly Assessed
;] Real ProPenY ❑ Nmually hssessed
ppes aPPlifant rnvn property in any aher If yes. what countyl What Taurg �atricCl Has �his deduCiw Deen requested on pmpeM1y I
munry in IrMana? n v� n u.. for artent yea(? ❑ Yes ❑ No