HomeMy WebLinkAboutMortgage_Opsal���, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
;i_,•,.. t FOR DEDUCTION FROM ASSESSED VALUATION
S, �' Slate Form a3709 (R71 / b-09)
��, Presaibetl by Department of loral Govemment Finance
INSTRUCTIONS:
To be filetl in person or by mail. �'�
Filing Dafes: 7J Real PropeRy: Must 6e completed and dafed in fhe calendar year7or which fhe tleduction is sough[ Counry Auditor
Must be filed with the County Auditor or County Recwder o1 the county whe2 fhe pmperty is located C
on or be(ore January 5 o7fhe immediatety succeeding calendar year. ewrder
2) Mobife /Manulactured Homes not assessed as Real Property: Musf �le with fhe CountyAuditor ollhe
counry whera the property is located dunng the fwelva (12) monfhs before March 31 of each year 7heG�BSON COUNTY AUDITOR
deducfion is sought .
See reverse side to� addifional insiructions antl qualilca(ions. �
AppGtant (owrrerw canvaa buyer-see resfictions on reverse sltle)
Michael J. Opsal
Tau(g DistnU Kay number/ le9al dascnption
Ft. Branch Township 2G78-24-204-000.996-026 / Pt Lot 11 Brenion Addition
Assessed vah» Ureal pmperry as ot Mortgage / Gonvact irWebtedness unpaid as W Mortgage l l
Marfh 1, artent year March 1, wrteni year date of app4
If no, what is his I her exact s�are
name on
Nama o� mortgagee or convact setler
Quicken Loans, Inc.
AEdreu of mortgagee or mnUaci seller (number antl strael, ciry, stafe. antl i
1050 Woodward Avenue, Detroit, MI 48226
ama oi assignee or oNer owner or Iwider oi mortgage
Address of assignee (number and sfreet t+ty. s+ate. antl ZIP wde)
Does apptirant wm property in any otner If yes. whal couniy?
counry in Indara?
❑ Yes ❑� No
anw�m
20 _ � 20 _
C�ZdIP.YJ19!lYLil:i
20_ � 20_
Counry
as
legal or equitada awnerl
❑� Yes ❑ No
someone other Nan spouu, inCinte with whom
Is �he pmperty in quesuon: MnuaPy Assessed
J❑ Real Property Q Mnually Assessed
•uestaa on property
`` Yes ❑ No
�
�
20 20'
I I We certify under ihe penalry o( perjury that Ihe above and foregoing infortnation is We and corred and that the applicant is a resident of Indiana and
owner / conVact buyer of ihe aforementioned Droperty on date gp9lication is filed. ,_ �
Fu0 re�Eent aEtlress of aool(cant num �fndEY£et c afe, an cotle � 1 � 1��
I ( `� l
���1�..�1� ' � 1.� � 1�L�if�
Person auNOrized by duty executetl Power o/Attwney or by IC 6�1.1-12-07
person (number arM sfraef. ciry, state, anC
Data (mm1h, day, yea�