HomeMy WebLinkAboutMortgage_Anderson (8)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun v r �
_ • FOR DEDUCTION FROM ASSESSED VALUATION
' sr�e � a3�oe �n i s o9>
' 1 P2srnbed EY OePartmeN of Laml Govemment Firwice
File
INSTRUCTIONS:
To be filed in persan or by maB with the CountyAWitor or Counry Recorder o! the county where lhe properry is Ixated. Form Aed x� :
Fifig Dates: 1) Real Pmperty: Must file during the year (or which the deducfion is sought. �.sbd�
2) Mobde /Manu(actured Homes rrot assessed as Real Property: Must fi/e dunng the hvelve (72) months
befora March 31 of each year the deducfion is sought ❑ County R
See reverse�ide (w additional instructbns and qualifications. �
�t no,
ot mor(qagea or mntrari seAu
Name
r�r.r^a
/%0300. QO�.
�/ Contract 4debtedness unpaid as of
wrrent year
rttlifate �elow:
N rtort9agee w oontrxt se�er (nimbe� and sfree; ctiy, sb�. ard 2
asvgnee w o�u owner or holder of rmrtgaga ,/
Y,
�f a��nce (numbrraM sheet �: state, and LP caCe)
di�nt own P�P�RY in any oNer Ir Yes. what counp?
Ind'ena? ❑ Yes
❑ No
DeAuction apprmv'd'ui ihe emrn+nt aF.
20 _ 20 _
s�y�wre a c�n a,a�m.
r�
��
someOne
�/� �
as d Is Ne appOnnt Ne sde
legal or equibble ovme(7
❑ Yes ❑ No
Is ihe pmGenY in quesbon: MnuaM Assesse0
�RealProperty �MmuailyAssessed
hbh0e Fiome OC 6
7- 3 -��
What Tadrg Dstria?
COUNTYAUDROR
20 I
I I We certify under the penalry of perjury ihat the a6ove and foregoing intortnation is t
owner I mntract bUyer of the aforementioned property on date application is filed.
,rae,re (aw�ers nm �ama)
dry, state, arM LP code)
, yZ
auMVaed prlson (numbuand snee{ cdy, slate, aM LP cotle)
Has Na dedudion Eeen requested m P�Y
for cvrrent Y� ❑ Ye5 ❑
—tl__ 20_
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