HomeMy WebLinkAboutMortgage_Schultz.t�-�* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
,e .. _ t FOR DEDUCTION FROM ASSESSED VALUATION
� Slate Farm 43709 (RS / 2-07)
� MM
' Prescnbe0 by Department of Local Govemmeni Firiance
File MaAc
INSTRUCTIONS: c7
To be filed in person or by mail wifh the CounfyAuditor o/the county where tlre p/operty is locafed. QU G!+ 9 2��
Fd'mg Dates: 1J Real Property: During the 72 months befae June 71 of the year fhe deduclion is fo be etFecGve.
2J Mobi(e Homes assessed under IC 6-L 1J: Between January 75 and Maich 2 o/the year the deduc6on is tp.ke_e8ectivp.,i
See reverse side (a additanal insWCtions and qualilcafions. ���6� �G3 h��
C/
Appicant (,wner wcorWae buyer-see ie�trictims on reverse side)
DisUid
Key
'sessed ralue of real popeM1y as M March 1, amenl yzar Mort9
QIR2(
whal is his / her ezacl share o( inieresl?
�
rame on record is diYeren� Utan Ihal of applican4 ��irate belwv:
oF mortgagee or conlract seller
Address of moM1gagee or contrad sdler (number and streef.
Name of asagnee ar dhef owner rn hdd
Address of assg�ree (rnrtnbu arM sheet,
Does appliceni awn property in any dher
cwnry in Indiana�
❑Yes ❑ No
De0uc6on appmved in the amount of:
20 �� 20 _
P
Signalure of CaunryAutliior
w — (.JOO . '�'--1 7S —n d. 1
/ ContraQ iMebledness unpaitl as of h1arU 1,
arM Z/Pcode)
morigaga
sfafe. aiM ZIP cotle)
If yes, whal cwnty)
couNrv
20 _ I 20
If wrtred
Counry
I Record � � I P � ��
e
Is U�e appfipnl Ure sde legal u equiUNe owne(1
❑Yes ❑No
spouse. udipla vrilh whom.
Is Ihe papert/ in question:
�eal Pmperty ❑ Mobile Home QC 61.
�.� aq- a��
C;l.�� �k ��'Ag — i
�r .. -� -- - � „�,
e �. : "
Drawer NO.......:..•.,......
: _
0
ard NO. . �..1-.a8��.. � —
���,��.c�c� ���� —
20 _ I 20 _ 20 _
day, year)
I I We certi(y unAer the penalry of perjury tliat the above and foregoing infwrtwtion is Vue and cortect and that the applicanfs was I were a resident of
Indiana and owner of Me afwementirned property on March 1, 20
qaLUe (pwne/s /ull rreme) , , Date (mmth, day, yea�
Person
address ot applicanl
by IC
otaulhaizeGpe�san (numbe�ands4eetaty.sfate.
and ZIP code)
Oate (rr�(h. day. yea�