HomeMy WebLinkAboutMortgage_Schuble.r "� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township
FOR DEDUCTION FROM ASSESSED VALUATION
s�a F� aa�os �a i zo»
�' �•» � presvibed by Departmenl d Laral Govemmerrt Firence
� � ile
INSTRUCTIONS:
To be fiied in person or by mad with the CourrtyAud'rlor o/ fhe county where the pioperty is located.
Fding Dates: i) Real PropeAy: Dunng Ure 12 monMs belore Jurte 17 0/ the year the deduction is to be eflecSve.
2) Mobile Homes assessed under IC 6-7.1-7: Behwen January 15 and March 2 of the year the dedutSon is to be eH��aB Z�p9
See reverse side /ar addifional insbucGons a�d qualificafions. p,P
Appiicant (ownerN mntrad buyer - see�4stricfau m r�v�e sde) i77a...: ,��'�%l
( / / n n � �
,a� � Ka��,���;G� 3oo-ooa.o3o-oa� ae �"'��7�
�d van,e or rea� �r a, d n�a�e� i. aneni r� �/ ConUaU uMebledness wPaid as oF March 1. Is ihe app6tanl lhe sde iegal a equitahle ame(1
ainerttyear /1
Q (�(J ❑ Yes ❑ No
whal is his / her e��] share af iirieresl7 I/ oxned with sort�eme dher Nan spcwse. irWirate wifh whom.
��
�qV:
Name aF rtntgagea or conVact seller �/�
Address of mortgagee w owiVad seller (n�mbu and streef,
Name of assgrree ar alher oxner a
Address of assg�e
code)
pu¢s app�ic¢nt own poperty in eiry athm If yes.
owmy in memna?
❑Yes ❑No
IS IhB PIOPOI�' 111 Gl95LM:
❑ Real P�operty ❑ MoMle Hane QC 61.
Has Uris tlaAUdion bea� requested on papaty
+a wrre�u r�n
❑ Yes—n'10
COUNTYAUDROR � - IL upKl'/C )Q �
DeduGion approved in Ihe amounl af: S��' U�w� `-"' ��
� zp �� 2p _ 20 _ 20 20
sg��!°��ry��, �� ��'— �'�y
1/ We certfy under the penalry of peryury ihat ihe above and toregoing infortrwtion is true and a _. _.e appGpnts was / were a resident of
Indiana and owner of fhe atorementioned property on March 1, 20 _ __
ara
of Alfonrey a by IC
person (numberand sfree[ d}: s(afe,
T �� �
Oale (mm(h. daY.