HomeMy WebLinkAboutMortgage_Hopple^'+a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
� FOR DEDUCTION FROM ASSESSED VALUATION
• $tate Fortn 43709 (R71 / 609)
S � f p�bed by �eP�rtl af local Govemment Finarxs
a
INSTRUCTIONS:
To be filed in person w by mad wdh the CounryAUditor or Counry RewNer o/ the couniy where the property is located� AN
FiNrig Dates: 1) Real PropeRy: Must file durirg the year (or which the deductlon is sought.
2J Mo6i/e / Manufaclured Homes not assessed as Real Property: Must file dudng the hveHe (12J months
6efora March 37 0l each year fhe deduclion is sought. J I�
See reversa side /or addiUonal insLucGons and qualifications. N�"L
App�era�t (aMner orm�traG buy`'see re� m reverse siYe) ._ `1 / _ _/i
m
Iq. W�12i �$ �Y$ I i12f 0Ydf2 Si12R Oi Vl(CRSI�
It narne at femd'a E'iRerart Ilun UuI
�/9-3/- `foo-o��.
Mortgage / Cantraa IMehtetlness unpaM es af
March 1, wrtent yrsr
IJame or mongagee a contract se9u 2 '
4`.(Jv1� ��Qoi
Address M mort9agee a mntrsct seDer (num6rs aM strael, ctty, state. aM ZIP code)
yssignee or ahu owner w halder of morigage
750 --00 p
Remrd numDer
Couniy Auditor
Is Ihe eppl'i�ant Ne sala
Iegal ar equifa6le ownrl/
❑ Yes ❑ No
DI-a1F'L'I• 1�°�...�.�,
�......
Card i\'O. ..... 3
150, ��� �w..........
Aq of assgnee (nurt�ber atree4 a+}: slate. antl LP wde)�� �� ��� ��
. /
Ooes epplipnt wm property in any other If yes, what muntyt What Ta�dig �¢trict? Has �his detlutirn Oeen requested m prapejty
munry in IrW"�ana? � Yes ❑ No for,wrtrnf Yra(1 � Yes ❑ No _