HomeMy WebLinkAboutMortgage_Bittner (5)�"'�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count 7ownship r
i� FOR DEDUCTION FROM ASSESSED VALUATION
1• State Fortn d3709 (RN / 6-09)
��• PrescnCeE 6y Department ot Local Govemment Finance
B�I/i
INSTRUCTIONS:
To be �letl in pe�son or by mail. ��h�
Filing Dates: 7) Real Pmperty: Must be completed and dated in the calendar year tor which (he deduction is soughL 4���
Musf be filed with the CountyAutlifor or Counry Recorder o( the tounfy where fhe properry is locafed ou Auditor
on or beJore January 5 of the immediately succeeding calendar yea� ��� ty Recorder
2) Mobile /Manu/acturetl Homes not assessed as Real PropeRy: Must �le with the CountyAuditor o/the
county where fhe pmperty is located dunng tha twelve (72) months be/ore March 37 0/ each yearfp�
deduction is soughC SON COUNTY qUnirno
See reverse side lor additional instrocfions and qualilcations. —"
Applicant (owner or conlract Duyer - see resfxtions on reverse vda)
Daniel R Bittner
Tazi isvict Key number l legal descdpUOn Record number Page number
/,�� 2G23-02-200-002.059-�tSW1/4 SE 1/4 353-10/Pt W1I2E1/2 2-4-10 �� �
value of real properry as o/ Mongage / ConVact inCeb:edness unpaiE as ot Mortgage / CanYacc inGeCteEness unpai0 as of Is Ihe apd��� Ne sde
! 1, airtentyear Ma¢h 1, wrzent year date of application legal or equitable ovmeR
644000.00 � Yes ❑ No
If no, what is h¢ I her ezad share of interest? II ownetl wiN mmeone oNer Nan spouse, indicate wiN whom
It name on recortl is difterent �han that ol applifan4 ��dicate bebv.: Is the D�PertY �^ 9ues6on: MnuaOy Asseued
❑� Real Property ❑ MnualyASSessed
Mobile Home (IC 6-1.7-7)
Name of mongagee or mnirsct seller
German Amencan Bank
Address of mort9agee or mnlraa se0er (numbera�H sfreet. ciry, state. and ZIPtoEe)
Po /'�� 3�0 ��i ma�n sf 0.s er .p�i 4�s
Name of assgnee or oNer owner or hdder ot morigaga
ACdress of assignre (number antl s(reef, ciry. state, and ZIP cotle)
Does appicant own property in any o�her If yes. what counry7 lM�at Taring Distnd7 Has ihis Cetluction been requested on pmperty
wun inlnEiana7 forwrtent eaR
ry ❑ Yes �❑ No Y ❑ Yes ❑ No
COUNNAUDITOR
DeducUOn aDO�'� �� � artwunt ot:
20 20 20 20 20 20 20
SignaNra of Camry Audiror Counry Date (month, day, yea�
1 I We certify under the penalry of perjury that the above and foregoing in(ortnation is We and correct and tha[ the applican[ is a resident of Indiana and
owner / conVact buyer of ihe aforementloned property on date applicatlon is filed.
SignaWre (owne/slull name) Data (mont�, tlay. yea�
O$/15/72
Full resident atlCress of apdiwnt (numbera slreef, ciry. sfafe. aM ZlPcotle)
10687 S Oakridge Est Haubstadt IN 47639
Person auNwaeC by Cuty executetl Power otAttomey or by IC 6-1.1-12-0J Date (mmfh. day, yea�
�ddress of auNOnzeC person (number arM sveel. uty. state, arM ZIP coEe)