Mortgage_Fontanillas R DU STATEMENT IO F MORTGAGE ES OR CONTRACT INDEBTEDNESS Township Year
C;; FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(Rl1/6-09)
Prescobed
by Department of Local Dowemmelt France Fiq���
INSTRUCTIONS: C .C.S in
lb be filed in person or by marl with the County Auditor or County Recorder of the county where the property is to atef7 EB tj m� :
Filing Dates: 1) Real Property.Must file during the year for which the deduction is sought �15Counry Auditor
2)be Mobile/ rch Manufactured 1 ofe each year the eduction i as Real Property Must file during the twelve(12)coo
before March 31 of each year the deductions sought ❑ County Recorder
Se��nerseside�.17 additional i tructionsandqulifxa�e) GIBSO/�C0l1gf�,AUDfTOR
pia WI OW /.tea �J 0 /{
,�% %l' a/6r61-.o RAJ. ‘GfO ' Vr1P Ciii 5- Pia
Assessed vile areal property as of Mortgage/Conrad indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appecarit the sole
Mardi 1;a>rrart year Mardi 1,current year date of applicatio n legal or equitable owner?
4 -r ❑ Yes ❑ No
If no,what is his/her end share of Interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,Indicate below: Is property in question:Annually Assessed
Is
Property ❑AnnuallyAssessed
Mobile Bane QC 6-11-7)
Name of mortgagee or contract sexier efoze.4
Address of mortgagee or contras sells, •. =