HomeMy WebLinkAboutMortgage_Schmitt (10)ie� � STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
s'. c FOR DEDUCTION FROM ASSESSED VALUATION
� w� / Stata Fortn 43709 (R6 / SO6)
PresQibed by Deparimem of Local Govemment Finance
INSTRUCTIONS:
To be /iled in person or by mail wdh fhe CounfyAuditor ol the county where the property is locatetl.
Filing Dates: 1) Real Property: Dunng the 12 months 6efore. ,lune �f oI the year the deduction is to be effec�`- F����
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 of the yea� th buctidh e/fectrve.
See �eJerse side for additional instn�ctions and qualifications. �-y„6� ��
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contract buyer- see
Distrid
Assessed value of real property as of
Macch 1, current year
what is his / her exact share of
If name on
on reverse side)
Key number / legal description `
. s�a �
a(� - a-3 - ��
Mortgage / Contrad indebtedness i
March 1, curtent year -
than that of applicant, indicate below:
or contrad seller
number
_ Page number t � �
l.e
id as of Is the applipnt t e sole legal or equitable
owner? ' ❑ No
If owned with someone other than spouse, indicate with whom.
—I I�s �he property in question:
�
� ��� ��.��� a, � � S � VE� S� /n-� 7T
Address of mortgagee or co �act seller (number and stieet, city, state, ZIP �
� g S��ln�
Name ot essignee or other owner or holder of mortgage j Jl u,
G. f� �
Address of assignee (number and st2et, city, state, ZIP code) ' /� ���a �
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Does appilcant own property in any other If yes, what county? What l
county in Indiana?
Deduction approved in the amounl
20 � 7 20 0 9
7 �
Signature
COUNTY AUDITI
20 I 20
County Auditor
-_�20
certify under the penalty of perjury lhal lhe above and foregoing information is true and correct and that the applicants was / were
lenl of Indiana and owner of the aforementioned property on March 1, 20
�[e-(o ners (ull nanme) / Person authorized by duly executed Power of Attomey
� // or by IC 6-1.1-12-.07
aS'
fdenl addres�Pf applicant � � �� Address of authorized person
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