HomeMy WebLinkAboutMortgage_Schapker (2)�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
� � �/ State fortt; 43709.(RS / 4-03)
, P2scribetl by Oepartment of Local Govemment Finance
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�Eoun - 7 Township�, Year
1i 1� 1' J J�J 1LJ'
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INS7RUCTIONS: File Mark
To be (!ed in person or by mail with the County Auditor of the county where the property is located. `�jja�� �d
Filing Dates: iJ Real Property: During the 12 months belore May 11 0/ the year the deduction is to be eflective. �J �
2) Mobi(e Homes assessed under IC 6-1J-7: Between January 15 and MarcA 2 of the �eanthe dediic'tTon is�to�be effective.
See reverse side )or additional instructions and qualifications.
Taxing
contracf buyer�ee resfrj¢tions on
side)
/ legal description
�� �LL�/�_�U Page number
Assess� vatue qfheal property�s of Mortgage / ContraG indebtedness unpaid as of Is the applicant the sole legal or equitable
Mamh current year March 1, current year owneR ❑ Yes ❑ No
If no, what is his / her�exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different lhan ihat of applicant, indicate below: Is the property in question:
�me of mortgagee or contrad sel}eJ �
Add�E55 01 ff�Ort9�nnp.nr rnnirad sel�lnum6er.add
Name of assigne, �� �) �
Address of assig���- —� \ [..�
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Does applicant o C-��� � �1� �
county in Indiaria / �_�_`
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Deduc6on appto
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Signature
We certify ur.
resident of Irn
Signature (owner's /ull n
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Full residen ddress of
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street. ciN._state. ZIP
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❑ Real Property ❑ Mobile Horne pC 61.1-�
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, � S a�y, ,,,/// , �uested on
- -�J'�.6�� ) Yes� No
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Date
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and correcl and that the applicants was / were
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person