HomeMy WebLinkAboutMortgage_Schustern STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
• Sfata Fortn d3709 (R71 / 609)
S,,,. / Prnsaibetl M Devartment or Lxal Govemment Fu�ance �
1 �
wsrnucnoNS:
To be filed in person w by mail wiUr fhe CountyAuditw or Counry Recorder o/ the tounry where tAe pioperry is located.
Fifing Dates: i) Real Pmperty Musf fde dunng fhe year7or which Ihe deducGon is sought
2) Mo6de /ManuFactured Homes not assessed as Real Property: Must file dunrg the twefve (72J months
before March 31 0! each year the deduction rs sought.
See reverse side (w eddilional instnxtions aM oualficatiorA. l:�a c
I vehm d rnal p�operty at d
anent yrat
what is ha / hu e� snare of intrlest?
Merd�1, /COntraa
�le�l ves
H name m remtd "s QRferent Wn Ihat af appOrant, intlicate Delv.r.
Name of rtnrtgagee ar
morn,7aqee or m,aaa
awner w halder N rt�ortgage
ffi�,
saee4 my. sbte, end Z!P oode)
"Y'O 10
Counry Audimr
Qeunry Remrder
Is ihe ep�l the sde
legal or equipda owneR
❑ Yes ❑ No
If aw�red wiN sortreme aher Ihan sPW�. udKate wtth whom
Dces e�n[ ovm property in any ottrl I I( yes, what munty.� I WAat Tadng
muntyinlndiana? I"1 ., I-1 ..
Dra���er NO.....���.....
Card NO. ... ��..........
---a35,_�0.�
�reN{�'(ow9e/s (u0 reme)
state,
2o I 20
Is tlx praperty in Quasuon: Mnu%ASCssed
❑ Real RoPenY � A"^�N �
year.
�_
Date (monN. daY Y��
�: �i
�_
: and foregoing infortnatlon is true and mrtecl and Nat the apP�ipnt is a resident of Indiana aM
on date applintion iv filed.
Penon au�tl Oy dWy rsecutetl Pw� o(Attvney N by IC 61.1-12�.7
Address o( aulha'veC pe,sm (numOeraM sbeeL d�: sbfe, an0 Z!P cotle)
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