HomeMy WebLinkAboutMortgage_Williford (2)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
• FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate Form 43709 (R71 / 6-09)
�' � Prewibe0 M Department af Lxai GwemmeM Finance
F' e a
INSTRUCTIONS.
To be filed in person or by mail with the CountyAuditor or Counry Recorder of the counry where the pioperty is located.
Filirg Dates: 1) Real Pmperty: Must file durirg the year for which the deduction is sought.
2) Mo6ile /Manufactured Homes rrot assessed as Real Property: Must h7e dunng the hveNe (}2) monfhs
6elore March 31 of each year the deduction is sought.
See reverse side lor addrtmnal inshucfbns and qualifications.
MP��t (ownFr.w oon7raC buy?r- see mTSlnct�s qp rever� siie)
•.IN�U'/�
P�SCd �2h10 Of fC
DAarM 1, �rrenl yPaf
Ii rw, whaf ts his / Iws e�C share oi interest?
-ooa.��14-pa8
htetlness unpaid as of Mortgage / Con7aC
date of appOfatmn
It name m recortl b Qiftuent than Nat of aPp&ant, trWUate b¢bw:
Name of mortga9ee mntraa seAer '_n �,}�n\
W �.l7LR� v��
ACdress of mort9a9ce w contraa seller (num6er end shae; ciry, so�te. aM ZIP code)
Nama of as4�ee w oMer ownu
ot a�gnee (number aM svee4 utY.
` � ZlQ�nry Audimr
❑ County Remnier
someone oNer than spouse� Nd�ate with whom
or
Yes L� No
Is ihe property in questian: Mnualy Assessed
_ ❑ Rra� amaertr ❑ amua�y wssessed
I� ry NP,���� G�GenY in any oNu I If yes. what counry? I What Tari�g OistrirlT I{or artent �dion heen n ted m D I—I No �
❑ 1'es ❑ No