HomeMy WebLinkAboutMortgage_Frohbieter"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
a FOR DEDUCTION FROM ASSESSED VALUATION
3. "' . ., Stata Fortn 93709 (R11 / 6-09)
� ` Presaibed 6y Departmefrt of Local Govemmenl F�rca
�ISTRUCTIONS:
Fartn fded wM:
To be fiied in person w by mail with fhe CountyAUditor or Counry Recordei of Ne county whe2 the property is bcated.
Fdirg Dates: 1J Real Property: Must file dunng the year /or which the deduction is sought. � ���� ��y p,�d���
2J Mo6de / Manu(actured Homes rrot assessed as Real Pruperfy Mus! h7e during the hveNe (12) months
befole Ma�ch 31 of each year the deduclion is sought C�. u ty Recorder
See reverse side (or additional instrucGOns and quali�cations.
Ap�l (o�vrer orcontrert buyer- see revriyyrms on ie�erse side) A , _ ' .
- � `> _
Y � P�P�Y �
Y�
/ her ezaG stare
If name on reooN is diRerm[ Nan Nat ot appfipnt, mAinie bebw:
Name of mntpagee a mntract se�er
Pddtess of mort9a9ee w contrad
owner or hdder o1 mortgage
ciry, state,
-300- aoo.
AACress ot assignee ( mber a�M stree; rdy, state, end ZIP code)
T � � E 5 c�
Oces a�'rcam wm propMy in any aher If yes. what county.�
munry m InOiana? ❑ Y�
❑ No
i
DeEumon app`wF.W in ihe amount of:
20 20 20 _
�f wrad �iN
3i -3 -�o
�� T�� �z '
DUNTYAUDR� - -
20 _
Signatum of Co�mry Autlitw Counry
C.T.
I/ We certify untler fhe penalty of perj Nat ihe a ve nd foregoing intomialion is
ovmer / mn4aU buyer of Ne afwementioned property on date applinlion is filed.
� aue (owriers me) 1
,b'
FWI resi0ent adtlres d appfmant ( umbe� a sheef, ciry, state. and IP mde)
� 1 t ��.,..�.. �
Person au�hor'¢eE by duy ezecuted Power d Anorney w by IC G7.1-12-0.7
Pdtlres d authaved person (number and sbee; cify. sfate.
Medness unpaid as d Is Ihe eppfaant Ne sde
� legal w epuibde owne/?
� lo`�� 5° ❑ v� ❑ r,o
spouse. indicate ritli xliom
P�PenY in Gunstion: MnuaM AssesuH
eal P(Oper�y � AMUaIIyA�ssed
� 9 f�l C
Has Ihis deduction been rWUe9eG m P�W�Y
��� ❑ Yes ❑ No
Dra���er NO. o���.�.........
5y38
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