HomeMy WebLinkAboutMortgage_Schmits (3)`° R�°a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
e+�-° .� FOR DEDUCTION FROM ASSESSED VALUATION
; � �2 Stale Porm 43709 (R4 / 70.07)
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� PrescnOed by Depanment of Local Govemmem Finance
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INSTRUCTIONS:
To be filed in person or by mail wifh the County Auditor of the county where the property is loca�ru_ M/� p� 9 2�02
Filing Dates: 1 J Real Property: During fhe 12 months before May 11 of the year the deduction is to be �1f�L't�v .
2J Mobile Homes assessed underlC 6-1 J-7: Befween January 15 and March 31 o e year the ded tion is to be eflective.
See reverse side (or additional instiuctions and qualifications.
_ GIESON CCUt. � v qUDITOR
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Applicant (owner
Distrid
on
Key number / legal description � Record number
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Page number �
Assessed value of reai property as of Mortgage / Contracl indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1 current year owner? ❑ Yes ❑ No
If no, what is his / her exact share of interest?
If name on record is different than lhat
of moAgagee or contraU seller
Address of mortgagee or contrad seller
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If owned with someone other than spouse, indicate with whom.
indicate below:
street, city, stafe, ZIP
of assignee or other owner or holder of mortgage
Address of assignee (numberand sheet,
Does applicant own property in any
county in Indiana?
Deduction approved in the
20 F) 1. / ��%� 20
state, ZIP code)
If yes, what county?
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What Taxing District?
COUNTY AUDITOR
20
County Auditor
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/
Is the property in question:
❑ Real Property ❑ Mobile Home (IC G1.
7-y5�18
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Has this deduc[ion been requested on
property for current year? � Yes ❑ No
20 O '/
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20 � J
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fy under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
of Indian� and owner of the aforemerylioned propeRy on March 1, 20
Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
� /� /�.� � �A��s�authorized person
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