HomeMy WebLinkAboutMortgage_Russell (2)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun wns ear
__ < FOR DEDUCTION FROM ASSESSED VALUATION
` � State Fortn A3709 (R71 / 6-09)
�' � Presrnbed M DeP��M af Lnd GovemmeM France
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INSTRUCTIONS:
To 6e filed in person w by mad with the CowiryAUditor orCounry Recader o/ tAe county where the piopeAy is located. ��
Fding Dates: 1) Real Pmperty: Must file durirg the year Por whirh the deduction is sought q�a�
2) Mobde /Manufactured Homes rrot assessed es Real Property Must fiie dunng the hvefve (12) mon(4F8SO C NTV pllt]�R
before March 37 of earh year the deduUion is sought Cdunryx At
See reverse side for additional instrucfbns and qualfications.
AooGONtbwxrorcontrarthwei.-seerestnrliorEan i . .,
������
Ii ro, what is his / her eract share ot interesY!
Name W rtmrtgagea or contraC seller
AdaRSS a rtrort9agee or mntraa seller
Name of assignre w oNeJ owner or �dder ot mwigage
Ooes applidnt own property in any other
counry in IMmna? ❑ Y�
DeEuction app�ovad in tlre artwunt ot.
20 _
Sig�Me W CambAUEimr
�_, o .
/ Contrxt[ L
wrtent year
riry, srefe.
state, aM LP code)
20 _ � 20
-UD
unoaid as
tt ovmed wiN someona
COUNTY AUDITOR
20 20
Counry
I/ We certify under Ue penalry of perjury that the above and foregoing infortnalion is t
owner I contracl buyer of the afaementioned prooerty on date applicatlon is filed.
�9�
� FW
i�
of author'¢ed person (num0er arM streel,
�n; ��a. �
cy ic
J �� � Rewro numeer
�?n / �
��� � I �
Yes U No
d P�v�Y in Gues�on: MnuaM A,sessed
Real ProPeNY � A^^�Y �
Has Nu Aeduflim been requested m p�operty
m� a,rte�rt yean � - - ^ .
20 � 20
Dra���er NO...�Q�..�-�.......
Card \i0. .... 595..........
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oate (mwu4 dai: Y�d
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