HomeMy WebLinkAboutMortgage_Scheller (4)"'�o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
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• FOR DEDUCTION FROM ASSESSED VALUATION
state Form 43709 (R71 / 6-09> �
�' - � Prrsm'bed �y DeC�rd of Local Govemment Fuiance
INSTRUCTIONS: -
To be fifed in person w by mad with the CountyAuditor or Counry Recorder of the caunty where the pmperty' t�d F
Fitirg Dates: 7) Real Property Must fite during the year for which Ne deducfion is sought. �� j� 2 � 2
2) MobAe / Manulactured Homes not assessed as Real Property: Must fife daring the (weNe (12J monNs
6efae Mamh 31 of each year the deduction is soughL C �
Sea reverse sid additional insWcf/
npp�rant(o or b �) � � n A n GJ�$ON COUNTY AU[
ws�ea���rre��n/asw Irn��eico�e
MarN 1. amaR year eQ�91
�i' o
`.
tf m, what is his ! her enG share oi interasYt
It rwne m rewrd a Gdrmnt Nan Nat af aDP�. NLkate Eebw
Name
County Audi[or
Couniy Recorder
�. OG�--6a'7 �._...��/� .�_..�--`�
I�ss unpaid as o( Mwigage I ContracS'v�deb[edness unpaid as d Is ihe epp�ari the sole
date of appOCatbn legal or equitade ameft
7� ❑ Yes ❑ No
H wmed wi� someone ortwl than spouse� 6Mlmta vAth xArorn
Is C�e ProOeRY in OuesCm: MnuaDy hssessed
❑ Real Properry ❑ nrmually0.sessed . . _
Addres oi rtnrtgagee ar mntract seDer (num6ri erd stree; cit� sfate, aM LP mde)
Name of assignea w othu mmer or hdder of �*^� '—
� �5��1$0.� ,
a��. .........
,� ��n�
D�•�\\'CT \�........
.o. ..... s`�93.....
Card
� zo � zo
I I We certity uMer Ihe penalry of {�rjury that the
owner f mntract buyer ot the aforementioned pro
COUNTYAUDROR
been re9uested on proprlly �
❑ Yes ❑ No
2a 20_ zo_ zo_
co�ruy oate (mowi. aar. r�d
'M toregdng infortnation is true and corteG arM that Me applinnt is a resident of IrWiana and
date appfintion is fiied.
rnee)
vncef-o.'� =n }�76
Pelson autho�aetl by dWy ezea;ed Pawmr al Aitomey or by IC G7.1-12-0.7 I Date
AEtl� af auNOr'¢EC person (numberelN sbee; ciry, state, e�M LPmtle) ,
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