HomeMy WebLinkAboutMortgage_Schmitt (7)^�n STATEMENT OF MORTGAGE OR
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FOR DEDUCTION FROM ASSES:
n State Fortn 43709 (R11 f 6-09)
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'w JUN a cu��
INSTRUCTIONS: ^�
To 6e lled in person or by mail with the Cowry Auditor or Counry Rernrder of the �nry w�here [ p rty is located.
Fi(ng Dates: 1) Real PmpeRy: Must file dudrg the yearlor which fhe deducfion is sought.
2J Mo6i7e / Manufactu2d Homes irof assessed as Real PrupeRV: Mus�l��r"�e�8'(7P�1 months
befo�ef� March 31 0/ eacA year the deduction is sought. G I85u
See 2verse side forpqdi(ional inshuctions and qualrficatioAs.
If no,
File Mark
Form Ned wilh:
�Counry Auditor
❑ Counry Recwder
� Key number /legal deuriptw� '� � �,(vV �0 �- / / � n � Recortl nupibef/ � Pa9e n,u,m � �/
ol G I% � -�, o:C o.
p�pper{y as of Mortpage / CmtraQ v�t� ess unpai0 as N Mortgage / ContraG'videbtetlrress unpaid a d is Ne applirant Ne sde
March 1, artem year � O O tlate of appLca6an lepal w epuita6le wmeY?
� Y ❑ Yes ❑ No
exad share of interest? 1/ ovmed wiM someofre other than sV�. indrate wtrh whom
on reodd is dMermt Nan that af applirant
N mortgagee or
Address of mort9a9ce or contraU se�er (nunbrl and stree4 �l: state.
Name W asv9�ee w othel owner or holdar d mort9a9e
AAtlress of assignee (nurtibar eM 51reeC my, sbte, aM ZIP cotle)
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01 u(�, sov. � �
IWhat Taring Oisvirl7
)UNTY AUDROR
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�s rt�e v�P�v in Quesson: nnrwally assessed
� Real ProPeNY ❑'���Y�
MoW7e Fiane (IC 6
Has Na deduGliM Eeen Rqunsted an pioperty
fw a�rent year.+ r1 .,_ _ f'l �
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I I We certify under Ue pe alry ot perj ihat the above foregoing informalion is true and cortecl and Mat the applinnt is a resident of Indiaria aM
owner / contract buyer of the aforemen'oned property o d te apD���tion is filed.
�iature (awneh
� Date (nmfi, daY. Y��1
�
JI resident add f a rcanl (numDer antl 4 tlty, sfate, end Z oode)
� so s' -=c Y7 3
xson auNO�aeA Oy duty ezecuced Puwer of Aitmiey ar by IC 61.1-12-0.7 �� (�N. �Y. Y��
Idress of authavetl pe�son (numbei aM street ciry. sbfe, and ZIP code) _