HomeMy WebLinkAboutMortgage_Schlottman��n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
� FOR DEDUCTION FROM ASSESSED VALUATION
�s�ate F«m aa7os (RS � z{17) �
°�� � Presaibed by Departmenl of Local Govemment Finance
File Mark
INSTRUCTIONS: 7
To be filed in person or by mail with the CounfyAuditor o/ fhe county whe/e the propeRy is loceted. � �tli%R 1 8 20�9
Filing Dates: i) Real Property: Dudng the tt months 6e/ore Juna 17 of the year the deduc6on is to be e/(ective.
2J Mobile Homes assessed under IC 6-1 J-7: Behveen January 15 and March 2 0/ the year the ded c6on is to be e8ec6ve.
See ieverse sidelor additional insWctions and quali(cations. ��s ��.�
4pplican� be er w mnlrad buyei - see re f6ons on r verse � e)
� � J
T�i Iric7' Key nu ber / legal desaiption
-� G
Assessed ralue of real property as d March 1. arrent y�r Mortgaga I Coritrai
airterrt year //
, what is his / her exact share of inie2s�?
It name on record is tlifterenl �han Nat of applicant, indipte below:
Name of mortga9� or contract seller � �
mortgagea a mnlraa seller (numbei a�0 sbeet. dty. stdte. and ZIP code)
Name of assignee w other owner or hdtler of matgage
of assignee (numberarid sfreeG city, state. antl
Does applicanl own poparty in any dher
taunry in InCiana?
❑Yes ❑No
Deduction apprwed in the amounl of:
20 �11 � 2b
as oi March 1,
If oaned with wmeone dher �han spouse, indicate with whom.
It yes, whel county.+ I what 7axmg olsirrc
COUNTYAUDROR
2p 2b _ 20
Counry
❑Yes ❑ No
ie property in questian:
Rral Pmperty ❑ Mobile Home OC 61.
Hes Iho tleEUClim �^---"
(ni�-.— `
aa��.........
p,�a,��er �o.........
91�9 .
t� . ...............'�i'
C1l (� •� Q� _" ��� 1 ��.
'f�� ` .,.1�n, dey, yea�
I
i I We certify under lhe penalry of perjury that the above and foregoing infortnation is true and correct and that the applirants was I were a resident of
Indiana and owner oi Me aforementioned property on March 7, 20
I.Aesitlent ad8ress of aF
SOS GtieV
Person authaized by duly
(number antl sfreel. city. stafe. arM ZIP code)
lree L.N h�v.�`e.�
ed Power of Albmey or by IC 61.142-.07
persm (numbarand sheeL aly. state. aM ZIP oode)
`i
Date (mmN, Day, year)
De1e (montA, OaY.Y��)