HomeMy WebLinkAboutMortgage_Deffendall (2)^'nv STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship vear
_ � FOR DEDUCTION FROM ASSESSED VALUATION
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S,,,, : p,esc,bea M cea�e� �� � cwemmem Frwrce
File Mark
INSTRUCTIONS:
F
To be filed in person or by mail wifh the CountyAUdito� or County RecoNer of the county where the property is located.
Filiig Dates: i) Real Property: Must file dunng fhe yrear lor whict� the deductlon is sought �, udiror
2) Mo6�7e /Manufactuied Homes rrot assessed az Real PropeAy: Must file during fAe hrelve (72) months ❑
6elore March 31 of each year the deduction is soughG Cou R er
Seerevers side7oraddrtionalinstrucGOnsarMqualificafions. C'� UDITOR
App&ant b -se^e/ mreverses"sle)
`Y�
ta ' 'rl i Kev / ai EesaiDtion Record numbu Pa9p�y�mbrl .
P�Y �
_ oo- ��. 03
/ Contract'uWebtedness unpaid as of Mortg:
wrrent year datc o
E'i.7�t tlian that ot appAtan4 hd'eate 6ebw.
Nartre at mortBaBee a
Address of mort9agee u mntrad senec(nampQF and st
U
Name ol assi9nee m oNer awner or hdder of rtprtgage
(number aM sfree4 ciry, sfate, arW
Daes ePpli�nt own properry in any oNu
m�,�uy�mae�a n .,--
D�uc6an
If ye5. what
tt ownetl wY.h sameone
COUNTYAUDROR
unpaid as of Is I�e eppliont tne sae
legal or equi�aWe amefl
�ir% ❑ Yes ❑ No
�e praperty in a�+esriwL awiaM assessed
Real Property ❑ Mnua�h/ Assessed
(or wrtent
�3 /�-c
eee� req�rstea «, vW�+�r
20 _ 20 _ 20 20 _ I. 20-- .. I 20 _
sy�amedCamNnwnw � �I'1VWXY ncvGl�-� �s�G
I/ We certify urWer the penalry of perjury that the above and foregoing intortnatiw, r .�,,,,,,,,
awner I contract buyer of the afwementioned property on date application is filed. ll�`1,�� e l. \ O••,�O f
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t, � � � ;t ca��a �o. .................
FWlresiEeneddre55ofappGrant( � raritlsLe tlry,stale,arMLPaotle) � � �
� 14I � . � , � IN �l� ��i3;�.----
� e�wo�a nr a�nr �e�:ea a�er oracmmey w oy ic �,.,-,z-o.� �,a� i�,romn. nar. r��
per�.,on (numberaiN stceG �+ty, sbfe.
20
7iana and