HomeMy WebLinkAboutMortgage_Scheller (3)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm 43709 (R71 / 6-09)
�' � PresaibeE M�PartmeM of Local Govemment Frence ,
INSTRUCTIONS: — �
To 6e filed in person w by mail wifh the CountyAUditor or Counry Recorder of fhe couniy whe�e the pioperty is �
FiHrg Dates: 1) Real Pmperty: Must file dunrg the yrear for which the deduction is sought.
2) Afobi/e / ManufaGUred Hortres not assessed as Real PmpeRy Must �ile daring fhe fweNe (72J �'
betora March 31 0( each year the deduction is mught.
r
Sae reverse side forad�tie�al insVucGOns and qualifical'an� � � Part¢� �
AppGtant (owner a uy�r _sg� nc m reverse � e) q . n. G IB
P�Pe*�`/
no, wM1at is tus I ttw exatl
7
Key �wmber / al d � � ^ ^��. �'� nu V I Pag `/ '—+�
�z
tru1'udebteEness unpaid as of Mortgage / Convar2 mEebieMess unpaid as d Is ihe appfxani ihe sde
A1e t Eate of aod��^ legal w equiqde owneYl
n Yes ❑ No
If name m �e�mtl a dAferent ihan ihat o( aPP��I trMirate beWw.
Name ot rtartgagee or contract u9u
Address ot rtnrt9agce a conitaG se�er
w othel owner or MNU ot rtvigaga
state, antl ZIP cade)
�—'^°�=w.u1 dfry IXA¢r � _ I li ye5. wh2t
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If wmed with someone aher tlan spouse,
GOUNIY AUDROR
zo_ � zo
Counry
Is ihe praperty in Question: MnuaOy Aswssed
❑ Real ProPeKY ❑ %��Y �
Mobile Fiortie fIC Gt.
Has Na deductim Eeen repu�ted m proprlty
ro, w�m y�n r� .,_ _ n
zo � zo
I I We certify under ihe penalry of perjury that Ihe above and foregoing infortnalion is true and cortect aM Nat the appiitant is a resident of IMiana aM
owner I contracl buyer ot ihe aforementioned property on date application is filed.
sfate, and ZIP cotle) �
p Cy IC G7.142-07
of auCror¢etl person (number and snaot, crry, sble,
(monN. daY. Y��