HomeMy WebLinkAboutMortgage_Schmits/
�
"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
�� � s�a F«n, aa�os (Rn i 5as) �\ .
�' PresviCeG by DepaNneM of Laml Govemmenl Fuance
w �i� File Mark
INS7RUCT10NS:
b 6e filed in person or by mail with fhe County Auditor or Counry Recorder o/ the munry where the property is loca[ed. F� �� ��:
Fifing Dates: 1 J Real Property: Must file durirg the yearlor which the deductiwr is soughl. � Counry Auditor
2) Mobile / Manufactured Homes rrot assessed as Real Properry: Must fi7e during the fwelve (12) months
befae Maich 37 0/ each year Ihe deduction is sotght. ❑ Cou^b Reco�der
See reverse side for additional inshucti�ons and qualrficafions.
AppGant (' r orm rraG buyer - see resLCl;ons on reveru sidej
T�p�g� }�TM�rl Key rwm0er / kqal desaiption RecorA number Page numDrl
'�Y� „�r 2_ /.. _i e_ 3 i- �M �n� 7,J '� - nrr q �� ii �,�.��i
�
�/QQ OO(i Idate
If m. what is Ius I hrs e�G share O( Nterest?
If riarrie m remd ¢ 6Remrt than Nat of aPP�^t uWicate bebw
Name of rtrortgagee w cmtract
mnlracl seller (nwnber and sfree4 �dY. steta. aM LP
other owner w hdder of rtprtgage
nonress oi assgnce �numcer arm snee4 dry, s+a+e. ana c�r cooe�
Does epplitam ovm property in any oNer
munry in Indana? � ..
couNr
�
If awned HiN someone othar than spouse. ind�mte with Mnm
�
w eQuitable wrtieYl
❑ Yes ❑ No
the P�oDertY in question: Mnually Assused
)RealRoPenY ❑����N�
_^1[`��I ��v�r
D f 91YG" � 0....!?�,`. ...... .. Yes ❑ No
Ca rd NO. .. a:`, :`.!'�..........
� (sq uix�_;�o
20 � 20 � 20 _ � 2U � 20 I • 20 _
Counry
Date (mob�. tlaY. Y��
I/ We certify under Ihe penalry of perjury Mat the above and foregoing informalion is W e and cortect arM Nat the applipnt is a resident of Irdiana and
owner / contract buyer of ihe a(orementloned property on date appliration is filed.
�nanue (owner9 N➢ neme) _ Date (rtrnfh. daY• Y�h
aM streef, dty, slate, and Z/P code)
� �(b S ��' /'i�}i Nf1�.�l1� (]
Person auNwaed Dy GWy ezecutetl Power o(AttarrieY a M IC Gl. t-72-0.7
person (number ard stree; cily. state. aiM ZIP rotle)