HomeMy WebLinkAboutMortgage_Meyer^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear �
• FOR DEDUCTION FROM ASSESSED VALUATION
•r — .• Sfate Fortn 43709 (R71 / 6-09) ' —• �
S � Presafhed q' DeOa�M af Lxal Govemment Firarce ' '
� � ' File Mark
INSTRUCTIONS:
To be filed in erson or b mail with the Coun Auditor or Coun Recofder of the coun where fhe ro � a
P Y N �Y �Y P PertY is located. '�A
Filirg Dates: 1) Real PmpeRy Must file dunng the year lor which the deduction is soughf. � .� County Audimr
2) Mn6ile / Manufactured Homes not assessed as Real Property: Must file dunng fhe fweNe (12J months
before Ma2h 3l of each year fhe deduclion is sought. - nty Recorder
See reverse side foradditional instrucGbns arM qualifications. GIBSON
Ap (ou+ierwcontrarl6uyer-�se/e�re ' onreverres'rle)
i _
Taa�y istrict Key wmEer / legal desaipCOn Recortl number Page numbni
i/mi �/n -l4�/D-/�O- DOd 7_OJ.S o�-J d- PO
WoP�Y �
If M,
If name an remd'a Qitt�t Nan ihat of aDp�ant, 6Wirate 6elow
Nameormort8a9ee«contrm2seller , �
Addmss of mort�Ja9� or mntract se0er (numbrr id stree4 �Y. �'e.
i as of Mongage / Contract hWebtedness unpaiO as of Is Ne aPP�� Ue sale
Oate of app0fatbn legal w equitable onnefl
Q O ❑ Yes ❑ No
H awned wi� mmeone Wlwi ihan . iMkate wltA whom
b C�e P�P�Y in Question: AntwaDy ASSessed
� Real ProPe�b ❑ �"^�Y �
n.�ae r� nc �t�a
Name al azsignee w other ovmer or Fwidu af mortgage .
AE of assignee (nvmDeraM stree; dry, slate, arM ZIP code)
��r A1E NI.J 1f7-3-�0 �-�Y �c-
D es epPlimnl ovm property in any o�her If yes. wha[ munt�? VJhat Ta�dng I
munry m IMa`u? 1"1 .,_ _ I"I .. _
cuan approved in ttre artaunt at
zo 20 20
requesteE on P�P�Y
❑ Yes ❑
COUNTY AUDf
--� I Iq�3C�.(x7 - --
zo Dt'a�ver i\TO.... �� a
sig�ature ar nuaaor • .��/ Y,'�`/" � C'a ' I ,, . . . . . —
I d 1�'�. . ...1-l'.� ��
i I We certify under the penalty of perjury thai the above and foregoing infortnati..�. ... _. , � a�d
owner I wntract buyer oi ihe aforemerrtioned property on date appliratlon is filed.
� SlgnaNre (ovmeh.
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Person aultwr¢eE
Pddress of auNOri
of
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