HomeMy WebLinkAboutMortgage_Schafer (6)^'� STATEMENT OF MURTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vea
__„ - FOR DEDUCTION FROM ASSESSED VALUATION
:• Stata Fortn 93709IR71 / 6-09)
S,,,. � PmsaiGetl by DepartrneM of Laal GovemmeM Frence
ile a
wsrRUCnoNS:
To be filed in person or by mail wNh fhe CountyAuditw o� Counry RecoNer o( the county wheie the pioperty is located. �
Filing Dates: iJ Real Properry: Mus[ file during fhe year /or which the deduclion is soughf. �u Counry Auditor
2) Mo6de /Manufactured Homes not assessed as Real Property Must file durirg the fwelve (12) �ans � 2��
6efore Ma/ch 37 0! each year Ne deduction is sought. ' LJ �^b R�w
See reverse side foradditiona/ insWCfnons arM qualiflcations. C'��
-�U-31-aoo -
Mard� 1. Oment'Rar •
I
If ra. whal a his / her exatl share of interest?
If name m recwd'a dMerent Nan that W aDG�ni. InOicate bebr`
Nartre of mortgagee «mnaad se0er
P �`TI
contraa seuer (numoerantl shee4 cdY, sfa:e,
rn holder of mOrigage
someone
ACtlress of azvyiee (numbc� aM stree4 �l: st°° � vH Z1P_cotle)—__
Ooes epptipnt mm praperty in any oUer
munryinlndiana? ❑ o
❑ Y� Di•a�ver NO. . Q7.1.
DeducUOn aPP�� m tice amount of. l...a.� t'd \TO, 5! O I. .
. . .
� � �aS,C�G 3, oo ......
si9nawre a camry
GIBSON COUNTY AUDiTOR
D�Remrd num0u Page numbrl
unpaid as d Is ihe appli�ant ihe sde
legal or eQUltable oxneY?
n Yes ❑ No
spouse,
IS UIC PfOPEfI`� YI QIIP311qf1: MIXId�' At52S5Cd
❑ Real Roperty ❑ ArmuaAy,4ssessed
Modle Fbrt�e (IC 6
�spN�t �tlrion Oeen requesletl m pmpury
,' ❑ YPS ❑
� � �
1/ We certify urWer the penaly of perjury Mat Ne above arM foregoing infortnalion is true and mrtect and that the applipnt is a resident of Indiana aM
oxmer 1 mntract buyer of the aforeme�nec�roperty on date applicatlon is filed.
I^37�'e� �lame) �i Date (rtrnth. daY. Y��
stare,
IWy execvteE Power a! AI[o•me'y m by
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pusOn (numbereM sbee( tlty,
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Da1e (rtronN, Eay, ysa�
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