HomeMy WebLinkAboutMortgage_Barthel^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C To Year �
_. • FOR DEDUCTION FROM ASSESSED VALUATION
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S � Presmbed M DeG�ment ot Laai Govemment Frwice �
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To be filed in rson or b ma�7 with the Co AWitor orCoun Recorder o� the coun where Me F0fp1 ���'
Pe Y �Y N �Y P�PertY is located.
Fi7irg Dates: 1) Real Pmperly Musl Ae duArrg the year lor which tha deduction is sought. uditor
2) Mo6de / Manufadured Homes not assessed as Real Properiy Must file dunng the hveNe (12) months
6efora March 31 of each year the deduclion is mught. ��
See reversa side Ioradd'rtional instrucGons and qualifications. GIBSO C
I M (awreror confrad 6uyet- see ' m ieverse sideJ n
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I T ' OistriU Key number / le9al desoiGtion � - O oL � RecoN nu� !� P� �� 1�
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vahm oFrpal p`apMy es W MoKqage / ConbaG inde6tednrss unpaitl as of Mortgage / Convacf Indebte0ness unPaid as of Is Ne ePPlhznt Ne sole
1, nvrent year Mfamh 1 wrtent year date of appGcatbn legel or equitaNe ovmel7
D O O � Yes ❑ No
I n no, wha� Ls hs � ner eraC sl,ara or inceresn - rc ovmea wim -----''_•_ ,.,«, w,�m _— ---- -
Name of mor�agea or contract seller
PdAress af mortga9ee w contred seDer (num6er er
Name af assignea w oNer owner m twlder of mwk
AOa�ass ot azs9nce (numbu sueef, dry, state,
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Dces apPlinnt wm property � Y aNer
munry m IMiare? ❑ Yes
❑ No
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COUNTYAUOROR � � l' (J(J � (,/v
cCOn approved 4i ihe artwnt ol: �
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� Sigrenue
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under ihe penalry of perjury that the above and foregoing infortnation is �
act buyer of the aforementioned property on date ap�cation is filed.
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Add25s of auG�atred prJSm (numberaM saeef, ary, sla(e, enE LP mde)
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