HomeMy WebLinkAboutMortgage_Schmitt (3)^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
;�__ FOR DEDUCTION FROM ASSESSED VALUATION
� Siate Fortn 43709 (R71 / 6-W)
, I PresaiEed by DepartmeN of Local GovemmeM Fl�nca
� FHe Mark
�vsrRUCnoNS:
Fodh� U
h be filed in person w by mail wifh the CountyAUditor or Couny Recorder oI the counry where the property is located.
Filing Dates: 7) Real PropeRy: Must Re dunrg fhe }rear Por which the deduction is sought. � � ��,,, YA�u�ditor
2J Mobi/e / Manulactured Homes not assessed as Real Property Mus[ file dunng the M�elve (72) monMs -��---�
6efore March 31 o/each yearthe deduction is soughf. Coun�ry �er
Seereversesideloradd'rfionalin ructnonsandqualifications. GIB TYAUDITOR
Appfimnt (a canlrad buyer see 2' m rerxrse sile) I
�
Tari ' Key `wmber / Ieg�af ewiPtim Rem�d numba Pagey+�
�' Wm— `7_.�o�L— ��� '�JCt'U. ��02 -Qo2� lJ/O �`7d�
rahx d rral propgty as W ( Abrtpane / Cantracl iriEe6teGr�s unpaiE as U Abrtgage I Canvaa mGebtetlness unG� a d Is IM aPV�t Cre sNe
1, arrent ye.v Marrh i, wrtent year tlate of appfiption legal or etryitatle bmreY.�
❑ Yes ❑ No
It no, what is ha 1 her exac]
U name on recaN is dirterent Uan that of a0P�4 ��ote below:
Name of mOrigagee wntract Seller �
_o,rerx� ,
Add�ess of �mtgagee a cmtract se�er (nu and svee4 ��% sbte. ard ZIP cade)
Name al assignee or other owner or hdder ot mortgage � �
AilCress ol assgnce (numDe� and stree4 �: slate, antl ZIP cade)
Does applipnt own property in any other If yes, what county?
tounry in Indiana?
❑ Yes ❑ No
If awned wiN somearre athg than spouse. iMirate weh wMm
• 3 —io
perty in Question: MnuaDy AssesuA
PmPertY ❑ArmualyPssessed
Has Nis detludk
ro� d,�n y�n
m propelty
Yes LI No
COUNTYAUDROR
DeEuction approved m tlre amount oE
20 20 2q 20 20 20 20
Sigfaave d CoumY Aue�rtor Caunry Date (month. daY. Y��1
I I We certify under Ne penalry of perjury that Ne above and foregoing infortnation is We and cortect and that Me applicant is a resident of Irdiana aM
owner I contrad buyer of Ne atorementioned property on date apd��n is filed.
,( sig�awre (uwne.s _ me� ) oate G,b„m. aar, raan
x '° � ��
i-
� � em atl of applirant (num0er aM street, tlry, state, antl ZIP cotle)
1 E �i�
Person authnizeE Gy AWy esewted Powcr o(AttcmeY w by IC 61.1-12-0.7 Oate (monN. Gay, ysa�
P4tlmss of auttrarsed person (number a� sbee( tlry, sfafe, antl LP mtle)