HomeMy WebLinkAboutMortgage_Schoffstallryn STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Yea
__,. s FOR DEDUCTION FROM ASSESSED VALUATION
� n Stale Fortn 63709 (R71 ! 6-09)
S ! p�y�p� py pepyRmenl of Loml Gwemment Friance
�"" il Ma
STRUCTIONS: F� � �:
To be �fed in person or by mail witA the CountyAUditw or Counry Recorder of fhe county where [he property is located.
Fifmg Dates: 1 J Real Pmperty: Must file dunng the year for which the deducfion is soughL ��f, V 1 Z� Counry Audimr
2) Mohde / Manufactu2d Homes rrot assessed as Real Property: Must file dudng fhe hveNe (72) mlYttthk � �unry Recorder
before MarGr 31 of each year the Aeduclion rs saght.
G `J.
Sea reverse side 7a additional inshuctlons end qualficafions.
e..,F,-�w��..�P.n.mn�buseryseerestriclionsmreversmside) �� / A1_ .. .. .__.. .....�rno
piopaty as oi
no, what Is his ! her e�2 share of inferes�?
riartie pn remrG is SMerent tlian that W aPpl
r/legald �'plirn � //U� r / � treco �morl raganunwe+
/ J o 0 /3�
�t�age / Contracl irde6tedr�s unPaid as W Mortgage / ContraH' ebtetlnrs unPa10 as d is Ne aPW�^t Ne sde
March 7, � nt ' / Eate ot aGP��� � a eWRahle avmeY.�
Q `� ❑ Yes ❑ No
H ovmed vriN someone oNer tlun spouse, i�icate wiTh whom
4 rtd'vate bebv.-. Is tl�e PmPen1' in Ouestion: MnuaM Assesse0
❑ Reai amaertv ❑ rw,!�aI.N.� . . .
Ndme Of rtart9a9re Or CMtrsct Seller (�/�
�J
PLdress of mort9a9ee or mnbaG se�er (number and snee4 �ly. sbte,
pym¢ uf assignee w other owner or holder of mortga9e
(numbCr antl stre¢4 �: �te, antl LIY cOtle)
poperty in any oNer If yes, whal counp?
oea�m«�
r_nr.riz.T �
v���„���� �io... ao� a
Card NO. ....���a.....
�. i�,aa�. �
?p p 2p _ 20 20 _ 20 _ 20 _
Sig�ature W Counb Aueitor Counry Date (monN, daY. Yea�
I I We certi(y uMer Ne penalry of perjury Nat the a6ove and (oregoing infortnation is true and cortect arW ihat Ne applipnt is a resident of Indiana arW
owner I mntracl buyer of the aforementioned property on date applicalion is filed.
61ona lowner's htll name) .. � Date (maYh. daY. Y��)
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antl sbeet, riry, state, erd LP ca
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'ofAttomeYa ICG7.142-0]
Y Sbeel. dty. SYdte, and ZIP cade)
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