HomeMy WebLinkAboutMortgage_Schmitt (8)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun wn ' vear
__ � FOR DEDUCTION FROM ASSESSED VALUATION
srace r-orm a3�os (Rn i s-0s>
,' �.0 � Pres�'n'Oed 7Y Oepartment of Local GovemmeM Fnarxe �
D "e
INSTRUCTIONS:
To 6e filed in person or by mail with the CounryAuditor or Counry Recorder o/ the counry where the property is located. Fmn med wim:
Filirg Dates: 1) Real Property: Must fJe during Ne year fir which fhe deduction is sought. un ud'ROr
2) Mo6de /Manufactured Homes rrot assessed as Real PlupeRy: Must file during the hveNe (12) rtanNs
bePore March 31 of each year the deduUion is �ht Co n er
GIBS N C NTY A DITOR
See reverse side lor add'rtlonal instructions and qualifications.
Mv��.(owne�9FN��buYE�-seeresL'cfio2to�e side) n � i J. i
:ed v�e of r�
7. mrent year
rc ro. what is h'a / her e� share ot intemst?
curtentyeer
�
date
If awned wik�
Rem`d number
or equilah'e ovm�1
❑ Yes ❑ No
If nartre on remrd is dAfern�t ihan Nat ot aPP��t md'uafi behw. Is th praperty in Questim: Mnualty Assessed
� eal Provertr ❑ Mo�d elNt�e ��C 6tt-
Name of mo�agee w mn�ct se9� __ �
����
Addrea o/ morcga9ee w mnbaa sell t�(nuni6e� aM sLeeL c
Dratiti�er i\'O. �.�,—
Nama of assi9nea or other ovmer or holder of rtqrtgage � ��3 �
.. . .. /Q �,q�,'
Pddress of a,signee (nvmberaM stree4 dry. state, aM LP Ca rd i\iO •.... ,
Dces aPPlifant own property in any olher It yes. what mun17/1 ••••• ••••••• •••• � ihis deduGion Deen requested m pmperty
counrymind'ana? I—I Yes I� No I••'•...� . . .. � arteNyeaR I—I Yes ❑ No
COl1NTY AUUITOR
Deaucfian apprwed in ihe artrount at.
20 _ 20 _ 20 _ 20 20 _ 20 _ 20 _
SignaWre of Co�mb Auditor ` ' CoumY Date (montA, daY. YEa�
�
I/ We certify under Ne penalry ot perjury that the above arW (oregoing infortnation is true and cortec[ arid that the applirant is a resident of Indiana aM
awner I wntracl buyer of ihe afwementioned property on date ap�ntion is filed.
�SIg�aN�e (a e(s rrre� Oate (month, daY. Y��
JV l� - ID —1,�
� FW rnsiden�D o1 eppGCan number ariC stree4 aslatB, ard LP ) ��� �^
O S �%
Pelsan authorrzed by dWy ezecvted Power al Atmrtmy w Cy IC G7.1-12-0.7 Date (month. OaY. Y��)
Adtlrc1s of authoraed person (numberantl sbaeS �: sfafe. en0 LPmde) .