HomeMy WebLinkAboutMortgage_Schwartzs°'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n T i Year
FOR DEDUCTION FROM ASSESSED VALUATION
state Form a37oB (RS � zo7)
�' „�. � Presrnbed bY DePaN^e^t W Loml GovertmeM Finance
File a
INSTRUCT70N5:
To 6e filed in person or by mad with the CountyAuO'rtor of fhe county where the property is located. `7�� ��
Fd'aig Dates: i) Real Roperty During tfie 12 months be/ore June 11 W the year the deduction is to be elfective. O'/�""
2) Mobile Hames assessed imder IC 61.7-7: 8eriwen January 15 and March 2 0/ Me year the deducti�'���e�pEGUy� A UDITOR
See /everse side la addtiortal insWcGons aid quaGfitations. Ul1fV I
Tadrg ..d ___.- K n bqf / 1e9� ��P�� � � Record n ba Page rwmbu
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�„d„e w,� Pupe,iy as or ma,d, i, a„an y�, Mwlgage / Contrad indeWedness unpaid as ot March 1. Is Ihe app6cant Ihe sde legal a eq�dtable owneR
a,Re�� r� 7oZ �
' ❑Yes ❑ No
If ro, what is his / her exacl share ot urierest? IF owned with someone other Uan spouse, indicate with wFam.
If rome m record is d'Afererq than Nal of applican4 �mte belav: Is Ihe properry in queslim:
❑ Real Pmperty ❑ Mdzle Home QC 61.1
conLact seller
Addr¢s or moAgagea « mnUaa seller (nwnbe� and �ce4 Mq. stata,
Nartre of ass9nee or Mher wvner ar holder of mortgage
AEdress of asvgnee
�e,
Does applicaM own propeny in a�ry dher If yes. what camly+
munry in Ind�ana?
❑Yes ❑No
Daduction appmved in Ue
2b
Signature of CountyAudilor
S
COUNTYAUDROR
ount oC
2p _ 20 _ 20 20
I
Cainry
1
D��:�„����.0..0..9.-.. �s -
ry
C:iC(1 ��. ......... �..... lo
20 _ � 20
I/ We certiTy under ihe penalry of pe�ury that ihe above and foregoing infortration is true and corretl and Mal the appGCants was / were a resident of
�ana and owner of Me afwementioned property on March 1, 20 _ __
Atlmrey or by IC 61.1-12-.07
aWhoraed persm (nwnberarMStreel. rdy, sfafe,
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Da�e (monN. daY. Y��
Date (month, Oay. yea�
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