HomeMy WebLinkAboutMortgage_Parish^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C 7o i vear
_ • FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R71 / 6-09)
,' -- ? Pfesrnbed Ey �eP�N o1 Local Govemmerit Fitaxre
INSTRUC770NS:
To 6e hfed in person w by mad with the CourttyAUdito� or Counry Recorde� o/ the counry where the propeRy is bcated. C�� F��r�' _.V
Fifirg Dates: 1) Real Property Must file dunng the year for which tha deduction is soughG � nry q��
. 2) MobBe / Manu/actured Hortres rrot assessed as Real P�perty: Must fi!e dunng the fvreNe (12) r�� N C U
6efora March 31 of each year the deduction is soughL � � AO�Y1[p�g+mrder
See reverse side for addiLOnal inshuctbns arM qualificaGons.
MP��ti°yyerdcarRfaG6vyer-seeresfif6'onsm _ s�e) n
Ic�s3eC rWUe of real p'aperty as d I Mard� 1 e/ Contraa 4
March 1. asrent year Nrtr.nt yeer
tt no, what is ha / her e�md sharc of interrst?
tt name an remrd's Qdlerent tAan that ot aDP��t bdi�a�e bebvr.
v
of mortga9ce w wntract seller (nurti6e� aM stree4
Name M assignee w other ovmer or holdu o} rtprt�age
P.Edmss of assigtree (number end stree4 Nry. sbte, and
DOfSE
counry
20
iranl awn property in any oNer I If yes. wha[ munq/1
n0iana?
❑ Yes ❑ No
COUI
appraved 4� the amount oF:
20 20 20
W Cowty Auditor
rc �e �;m
ALIDROR
Caunry
I I We certify under ihe penalty of perjury that the above and toregoing iMortnation is W�
owner / mntracl buyer of the afommentioned pmperty on date ap�ption is filed.
��bire(ownnfsh�rome)�� p ,
,�
`' I Futl'f'esiient address ot applkant (num6e�and sLeet,
}` ��I � S-f£fl,l,.:�. '��
i
Pe1mn authaaed M dWy exew:ed Power of Atmme!
auNOraed person (numberarHsbee; riry,
�re, antl LP catle)
i� �TiIC r� -1
by IC 67.1-12-0]
-!/��
�
SPOLL52�
or
Yes LI No
Is the ProPenY m 7uestion: MnuallyASSessed
�teal ProperlY Q AMU2�ly ASSe55ed
- U / /��
:tri Has Ih's Eeduaion Geen re9uested m P�Y
tor aurent Y��' � Yes ❑ N<
20. _ .. 20.___ _.__-20
I� �� �'U0. �
Dra��•e►• NO. ap,�.�........
�/7%7
Card NO . .....................
Date (mmfi. tlaY. Y�h
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