HomeMy WebLinkAboutMortgage_Schafer (2)^�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ovmship Year
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� FOR DEDUCTION FROM ASSESSED VALUATION
� • State Fortn d3709 (R71 ! 609)
� d Presoibetl by Departmenl of Loral Govemmenl Firence
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1STRUCTIONS: F� q� �_
To 6e ned in person oi by mail with the CounryAuditor or County Reoorder of the county where the property is located. (�
Fifiny Dates: 7) Real Property: Must file durim� tha year for which the deduction is soughL A� 1��Yr�t� Auditnr
2) Mo6i7e / Manufactured Homes not assessed as Real Property: Must file danng the hveHe (72) months
6efora Malch 31 0/ each year the deducfion is saqht. .'J, ty Recorder
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See reverse side lor edditional instrucUons and qualificafions.
ppWc�AfjLpmerorconvacfbuyer-see mreversesde) v � A AUDITOR
T g istri KeY �uu
A�sed rWue aF 2al D�ape as d
MazM 1, amerLL year
�{ M. W�18I 6�16 � ilf! 0%d� 5�13f8 Of Vl{CIESl7
rwne m �ecad a SMemnt than ihat af aPP�^6 cWicate belrnr.
Name of �mtyya9ee or mntrad uller
nearess ot mortqagce or m,o-aa sen
Name of assignee or other avmer w Y
sbee4 �Y. state.
PLEress o( assignee (numDer aM stree; dry, state, antl ZIP code)
Dces aPpli�ant own MoPeNY in any aNer If yes. xfiat
counry in Ind'ana? ❑ Yes ❑ No
Deductlan avP�� in U�e
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Caunry Audi�cr
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U I Matnaoe / Conraa
Page num6er
Is Ne applkanl ihe s3Te
legal w W�+itade awrcY!
❑ Yes ❑ No
It owned wiN someone other Man spwise, iMicate wiC� x7�an
IS U1C DbDeKY VI QIIPSbOfI: MIIU3II`f ASSCSSLE
❑ Real PmpertY ❑ ��Y �
1 Mobile Home (IC 6
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I/ We certify under ihe penalry ot perjury that the ahove and fo'_„_..��_...,.., e
owner I contracl buyer of the aforementioned property on date application is fiied.
shect, tlry, sbte,
w by IC 61.142-0J
person (numDer an0 svee4 NY. ��. �
'�n re9uested on P�WenY
I ❑ Yes ❑ N<
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I 20
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ihe applinnt is a resident of Indiana aM
Date (rtmih. daY. Y��)
Date (monN. tlay. yEa�