HomeMy WebLinkAboutMortgage_Bittner°�+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
�_, _. FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fam C3709 (R8l 2-07)
�� a�� r Presmbed by Department of Local Govemment Finance � �
File Mark
INS7RUCTIONS:
To be filed in person or by mad wrth the CountyAuditor of fhe coun[y where fhe property is located. 2 Z��g
Fd'mg Dates: 1) Real Property: During fhe 12 months belore June i7 0( lhe year the deduttion is to be eflacGv�AY 1
2) Mo6r7e Homes assessed,mder IC 6-1.1-7: Behveen January 15 and March 2 o)Ihe year the deductirn is to be eflective.
See reverse side /ar addifional insWctions and qua((cafions. �� ��a�,
her or mnhad btrye - see re m rt
Key r
/ r
.�e of real poperty as of Mardi 1, anenl year
his I her e:ad share of interesl?
If teme rn recatl is dilferent Ihan that of appicant, i�cale below:
Name of mortgagee or cmtract seller
Address of mortgagee or mnlrad seller (numbra and stree4 dty. sfate.
Nama of assignee or df�er ow�r or
L' �rL
Iwant o�m property in arry dher
Indana?
❑Yes � N�
�
city, Nate, and ZIP rnde)
1 indebledness unpaid as of March 1,
aoo
If owned wiUi wrtieone oU
VJhat Ta�dng Disiric�?
�1'a1VC1' 1��..��!4!..�.t:....
amounl of: �
�� c.��-�i �o. ....�33......... �—
P ��►,aoo.°°
Is ihe applimnt �he sde
❑Yes ❑No
spouse,
Is ihe property in question:
❑ Real Property ❑ Mobile Hwr�e QC 61.
Has Uvs deduction been requesled on poperty
fw wrtenl yraR
❑ Yes ❑ No
20
Oate (mmN, tlay,
20
I I We cer6fy under the penalty of perjury ihat the above and foregoing infortnation is We and correU and thal the applinnLS was I were a residenl of
Indiana and owner of the afwemen6oned property on March 1, 20
._j..__ �_..__.u, aa _�x...� Date (nronih. daY.YeaA
autlioraed hy duly execuled Power
of aultrnaed persa+
city, state. antl ZIP oode)
w
dty, state, arnd ZIP mAe)
�ale (monN, day. yea�