HomeMy WebLinkAboutMortgage_Steckler (5)k
"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun To�
__ . FOR DEDUCTION FROM ASSESSED VALUATION
State Fartn 437091R11 / 609)
�` �/ presaibetl A' ceV��m al Loral Govemment Fu�ance
� Fi
INSTRUCTIONS:
To 6e filed in person w by mail wiM the CounryAuditor or Counry Recorder of the county where the property is q F� flF
F�T'vg Dates: 1) Real Property: Must file dumg fhe year for which fhe deducfion is soughG �T G 2�
2) Mo6ile /Manufactured Homes not essessed as Real Property: Must fite dunng the tweHe (ttJ monfhs
before March 37 0/ each year the deduction is souqht C. �. �� ❑
See rtverse side !or additronal instructions arM qualifications. V�'
AppGn wneroroonvadbuyer-seeresviceonsonleversesitle) _ "1°� COUNTYAUC
Aivn�c-C�
Ta District Key num6er / legal desaiption Reca(d number
a -a �� - 300-00�. o°a.-oa.
rdue d mal propri:y as d Mw�qage / Contract mEebted�ress unP� as o( Mortgage / ConYaC iMebtedness unDaid as o( I
Counry Auditor
Counry Recorder
�
�nt Ne sole
1, axrent year Martl� 1. airtent yrar datc af ep G�tian legal or eQUitaNe o.meh
rp, xfiat is h's ! her exatl sha�e of interest?
narna on 2ard is E'iRrlent ihan that of aDP��t ��� below.
Nama ot rtxutgagee m m�traa seller
Atldress of rnort9a9ee w canbacl seU
Name of assivnee or otlm! ommer or h
�9MJe
�
cilY. sra:e.
AGC ot assgnce (numoeJ arw sueeS a+}: s,a:e, aJro tir 000e)
�T Sl,J 18-�{-1 o ,SS
Dces eDW�mnt rnm property in any oN r If yes, wha[ munty!
muntyinlMiaeu? n ., n
Deduttlw
20 � 20 � 20
` . . v/ uv r�u
I/ We certify �nder �he penalty of p� ry that Ne
owner I wntract buyer ot �he aforemerrtioned pml
3na�'we (ownef: MI name)
Full resident adtlr�s o( epp�cant (numeerana sbee4 ary, sfate,
/dLaa ,�,�u, µa �../•.+ F-�a�y`z/��;1�
Person au � ed by Euly execvted Power W Aitomey or by ICE
Pddrets W authoraed person (number antl sbaet Gry stale, an
JDO D ❑Yes❑No
If owneC v.ith someone o er Ihan spouse, indicate wM xTnm
�Is e properry in pues6on: Mnually Assessed
Real PivPeRY ❑ Armua�h!ASSe�� . . _
Wh2l Ta�dtg
S i Ec i< «n, /�oc3� 2
/y� �
1.3�A/A4L� J � �
la -yGa3 -
20 20 _ 20 _ 20 _
Counry Date (month. daY• l��l
nd foregning infortnation is we and cortect and that Ne applicant is a resident of Indiana arM
date application is filed.
`