HomeMy WebLinkAboutMortgage_Schneider"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C n hip Year
_, ; FOR DEDUCTION FROM ASSESSED VALUATION
Sfata Fortn 03709 (R77 / 6-09)
�' f Presaibed by OeP�^�M of Laral GovemmeN Firerce
� �
INSTRUCTIONS:
Farm Ned w%h:
To be �Jed in person or by mail with !he Counry AWitw or Counry Recorder o( the county where (he property is loca�,+ �
Filirn) Dates: 7) Real PiopeRy: Must file durirg the year for which fhe deduction is soughf. �' Counry Auditor
2) Mo6ile / Manufactured Homes rrot assessed as Real Property Must file dunng the tweNe.����tf`cQUN Y���n Recorder
be(ore March 31 0( each year Ne deducfion is soughL tY
See reverse side (or addifional insWCtions and qualificafions.
i10v�m( arcontraub�ryer-seeresn"raa�s renuseside) L
Q�nna�M. � �i- �� o/r�n ��.r�il�2.�1 �an
a real
Y�
on
ot rtartgagee or contraU seller
c c. -iu- �
Mor(gage / ContraR
Maml� 1. artent �e[
6tEit2te belrnr.
Addres U mortgagce w mnvsd se0er (nunber aM sdee(
Name ol assignee w otliu owner
o�m property in any other
a� ❑ Yes
DeCUCGan app�weG in the amount aE
state,
No
code)
az
btetlness unpaiE as of Is Ne appiMant Ne sde
legal w epultaWe mme(.�
�Yes ❑ No
spoum, iMimte with whom
Is ihe P�G�Y in Gurstion: Mm�aM Assesv.M
� Real Pruperty ❑ ArmuallyAsered
SCNVESD�2 G�EG�.Y �
uyes..�+,acco��yr wna�T SCI{,�GXQt/C� ��-�/I�-fT W"� 7 No
20 _ � 20 � 20
Auditnr
20
�; - 51���
[V _ � 20
�Y. Y��
I/ We cert'rfy under ihe penalry oi perjury Ihat Ihe above arW (oregoing infortnalion is We and cortect arW �hat Ne applinnt is a resident of Indiana arM
owner / contrad 6uyer of the afo2mentioned pmperty on date application is filed.
1�4+R (PwneYS fidl ry�ne) . 1 r Date (monfh, daY• Yge�)
Person
Date (manN, QaY.
person (number aritl sbeef. dy, state, aM LP code) . I
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