HomeMy WebLinkAboutMortgage_Cueto"'�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou s' ar
_, • FOR DEDUCTION FROM ASSESSED VALUATION
. � State Fortn 43709 (R71 / 6-09)
�' ,�� presvfbed by Departmem af La�l GovemrtreM Fuarce
'le Mark
�7RUCTlONS:
To 6e filed in person a by mail with the CounryAuditor or Counry RecoNer o/ the county wfiere the properry is located. F� � �
F�7ing Dates: 1) Real Pmperty Must file during the year /or which the deducfion is sought. � Auditor
2J Mobile / Manufactumd Hwnes not assessed es Real Pmperty: Must file dunng the hvelve (12) months ���der
6etore March 37 0( eacA year the deduction is sought. -
See ieverse side for additional instrvctbns and quali(cations.
IAO ( wneracontraG/lhrer-see2sltli�+�sanraverse '
# real proprJry az
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'Abr(qage/ Contract 4dehtedness unpaid as at Martgage / Contrarl inde6tednes
March 1, airtent yeet date of aPP� .
tt awned wi� sameone dher spouse,
on 2md'a &tturst Rtan that ol app6ranl hidkate bebw:
Name of mortgagce a contrw
qdares m �rnrtyagee «mno-aa se�er
w other owner or halder of martgage
of asd9nee (numbelaM streeL dry. stete. end LP code)
G�-ant own property in any dher
Indana? r-� ..
20
Si9nanne W
20
I/ We certify under Ne penalty of
qx�ner I mntract buyer of ihe aiq�
Ptldress
•� " .. •'
--
ar equltable o-mu(1
❑ Yes ❑ No
�Is" p�operty in Question: MnuallYhssessed
'sf "� �Oaem ❑ M„���,.,
It yes. what munt�? �.P%ut Tari�{q'Chstiicl7 I Has Nis
� / / / for arre
V
COUNTY AUOROR �
20 _ 20 _ 20 _
that Ne above and foregoing intortnation is Vue ai
ned property on date application is fiied.
arM LP
ar
�,�
❑ No
20 _ � 20
i.�o r..ma� dar, ree�
�.�. a/� -
Dra�rer NO.�V,I.�.......
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