HomeMy WebLinkAboutMortgage_Schulten^�� STATEMENT OF MORTGAGE OR CONTRACT INDE
__ _ FOR DEDUCTION FROM ASSESSED VALUATION
Slata Form C3709 (R71 / 6O9)
� y,. � Presaibe0 by DepartmeN of Loral GovemmeN Firence
��.
I!�[�'�i�■�:iuu"'�i �i8l:I�,
�, ' �, -
. ;r,?�!�
wsrnucnoNS:
F� wiN:
b be filed in person or by mail with the CountyAuditor or Counry Recorder of the counry where the pmperty is locate`�j�
Fitirg Da[es: 1J Real PmpeRy: Must file dunng the year7or which the deducfion is soughG mon! �h�s ` Counry Auditnr
2) Mo6de / ManuFadured Homes rrot assessed as Real Prt�perty: Must file dunrg the tweHe (1�JItSSUN CO NT�A Urs���1�
before Maich 31 o/each year the dedudion rs sayht. L'J '�%°°'°7 R��
See 2versa side for additional ir�tr4ctnons and qualifications. �
Pd raWe d real Rw�Y as d
1, a�l year
what ts ttis / her eud share
on 2mtd is drtle2nt than ihat
�oa- D�o.GC�S-oby `�'"�v P�l� a5
�r�s unpaid as of MatBa9e I Contrae uWehtedness un0aid as of Ls Me ePP��t the sde
/'\ � Eate ot avP�� �gal or ewttade o•.ien
vli`j ❑ Yes ❑ No
tt owned with sameone otl�er IAan spase. iM'�te wiN Mmm
Atldress d nortgaga m mntract se0er (number and straet �Y. �m. aid LP mde)
Name of assignee or dM owner v hdder of mortgage
.naaress m assynm (� e,�e sueec an. sa+�.
�n ' Q .
Dra���er ��.. �"�' .....
� � ,.1� :.......
�3rd��'•�`��Op,�i
Is the properry in OuesSm: MmieAy fv�sesseE
❑ Real PtoPertY ❑ �^�Y �
I N1mt Ta�dng D'atriG? I Has this deductiai Eeen reQuesteL m PmpenY
ror wrte�n yrzR � ves
❑ No
COUNTYAUOROR
1 �a— 20 2°— 2°—
Counry
oa� (.m.un, ear. r�tl
I I We cerofy uMer Ne penatty ot perjury that the above aM foregoing infortnation is we and mrrea and that Ne applipnt is a resident of IrMiana and
owner I mntrad buyer o( the afo2mentioned property on date application is filed.
inaGUe (owne/s!u➢name) \ n . � Date (�. daY• Y�/)
Power o(Atlomey or Cy IC G7.
Pdtlress of auCnr'¢ed person (num0er antl sbee; tdy, state,