HomeMy WebLinkAboutMortgage_Schlottman (2)a�'� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i = FOR DEDUCTION FROM ASSESSED VALUATION un sn' vear
! SUte Fwm 43709 (R6 f 5-06)
� Aesvi6ed by Departmenl of Local Gwemmenl Finance ��ool
INSTRUCTIONS: ,// F�y�w�}rK
To be iled in person or by mail wfth the County Auditor ol the county where the property is located. �r 1 a Q U�TOR
Filing Dates: 1) Real Property: During the 12 months befoie June Il of the year lhe deduction is to be eNp� �i�UN�Y AUD
2) Mobile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 of the ��Me deduction is to be effective.
See reverse side for additional instiucUons and qual�caUons.
Applicant (ow�er or contract buye� - see restrictions on reverse side)
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Taxing DisVict Key number! legat description Record number �
C �h�Q�y�L�. �O-/3-/.3 -�/(/ �' Q�6 . l70 -,�e number l� V
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year Maroh 1, current year owne(? � Yes � No
/
If no, what is his / her exact 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 the property in quesdon:
❑ Real Property ❑ Mobile Home QC 61.1-7)
��e of mortgagee or contract seller � `
Address of mortgagee or contract seller (number and stieet, city, state, ZIP
Name oi assignee or other owner or holder of mortgage
Address of assignee (number and streef, city, stafe, ZIP code)
Does applipnt ovm property in any other IT yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for wrrent year? QYesO No
COUNTY AUDITOR
Deduction approved in the amount of:
20� 20�� 20 20 20 20 20
Q 1 f
Signature County Auditor Date
I/ We certify under the penalty of perjury that the above and foregoing infortnation is We and coRect and that the applicanLs was / were
sident oi Indiana and owner of the aforementioned property on March 1, 20
a.yna re (owne/s ll n e Person authorized by duly executed Power of Attomey
or by IC 6-t.t-12-.07
F�II esi nt address oi applicant Address of authorized person
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