HomeMy WebLinkAboutMortgage_Schlottman.� °•n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
� Slale Fwm 0.3709 (R8l 2-07)
�' 1 prp,s,,nbed by Depatlment of Loral Govemmenl Firence
�NSrnucnoNS: � � �le �{ �
To be filed in person or by mad with the County Auditor o/ the county where the pioperty is lotafed. � j�
Fiing Dates: 1) Real Property: Dunng fhe 12 monfhs be/ae June 17 0( the year the deduction is fo be effective.
2) Mobile Homes assessed under IC 67.1-7: Between January 75 and March 2 0l the year the deduc6on is to be el/ective.
See rsverse side (a additional ins6uc(ions a�d qualifications. MA.� O'� ��Q�
icant owner ar s�@ 29ricti�94� ar reverse sde I .�A�- �-yr� �J
Mp ( iAb�er- U / 1.1.. .. � ) I Iwn �.�'IAMAM O�/a<., N/�.
�� NV� l — � —
Assessed rdue oi teal PW�Y as d Matd� 1. a+rent Y�r • Mortga9e / ConU
airre�� �
��tat is his I Frer exacl share of interesl? I �
If reme m record is d'A(erent ihan Ihat of applicant, irWiote below:
Name of mortgagee or caniraG seller �
Address af mortgagee or cmlraC sella (number aiM 3�eef, aty, state, arid
Nartre of aui9rree a ottrer o.vner w hdder of martgage
Address of azvgnee (numbei aM street, tity. 9ate, arW Z/P code)
Does apyicant a,m property in arry othar
tounry in Indare?
❑Yes ❑ No
Deduction apprwetl in �Ire amounl of:
9�=�Z-��
If yes, y `
� " •
— �
20 _ - —
�
7. � Is �he appfiont Ihe sde Iegai w
If owned with someane olher than spouse,
�
�- / / �y' SDO
�0
Counry
20
❑ No
question:
y � Mobile Home (IC Gi.
: dedudion heen requested on properry
nt yrvR
❑Yes ❑No
20 _ I 20
�Y. Y�A
I/ We certify under the penally of perjury ihat the above and foregoing information is We and cortect and that the applicanfs was ! were a resident of
Indiana and owner of the atwementioned property on March 7, 20
�.�,TOK\ �.
Aeni address af applicanl (
� �Oial $ .
auUafrzed by duy exeate
: of aulhor¢ed persa� (nw
s(reet nty. sfate.
a by IC 61.L12-.07
aty, slate, aM ZIP oode)
Oale (monfh, daY.Y�A