HomeMy WebLinkAboutMortgage_Schwomeyer (2)'°'�► STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALU7� � E
Sfate Form 43709(R11I6-09) r 1
� � presaibed by Department of Loql Govemment Fnance
File Mark
�►�NSrRUCrrorvs: FEB 4 2013
Fortn filed With:
To 6e filed in person or 6y maii with the Counfy Auditor or County Recorder of the county where ihe property is located.
Filing Dates: 1) Real Property: Must fi!e during the year for whieh the deduction is so ht �, County Auditor
2) Mo6ile / Manufactured Homes not assessed as Real Property: Must duri e(12) months
beforo March 31 of each year the deducfian is sought ❑ County Recorder
See rev se s e faradditional�structfons and qualifications. GIBSON COUNTY AUDITOR
� APP�i Qr cr 4�ve sgB re�rictions qp reverse side) I
Key number��l deJ.sai'ptio�
�/ �
Assessed value oFrieal property es oi
March 1, currerrt year
if no, what is his / her e�cad share qf interesYt
/�E �' tJ�J�
Mortgage indebtedness unpaid as of Mor�gage I Contract indebtedness unpaid as of
March 1, �a� ���c� date of application
if name on record is difrerent than that of applipM, indicate below:
Name of mortgagee or contracl seller
Address of mortgagee or contract seller (num6er and street city, state, and Z!P code)
Name of assignee or other owner w holder af mortgage
Address of assi � l"�� � I-'
f`;, y �mt, t�i n,. /�
}� � �.
Does applicant � � .J. �wy /"!
county in indian /
la - �v�o
Deduction appro
20 i tu � 20
P ge number
�O
Is the applicaM the sole
legal or equdaWe owner?
❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom
What Ta�dng District?
UNTY AUDITOR
20 20 _
County �
Is the property in quesdon: Mnually Assessed
❑ Real Property ❑ ArmuallyAsses�ed
Mobile Home pC 6-1.
Has this dedudion been requested on property
for current year? ❑ Yes ❑ No
20
Date (month, day, yea�
20
I! We certify under the penalty of perjury that the above and foregoing information is true and corred and that the appiicant is a resident of indiana and
owner ! contract buyer of the aforementioned property on date application is filed.
...,...,.� �e.....erc R.n .,fl..,o� Date (month. deY. Yaa+�
F� !I resident address of appiicant (nu 6er and sLee� ci(y, state, and ZIP code)
C� /� s L a o �vv�,� �( _
Person author¢ed by duly executed Power of Attomey or by IC 6-1.1-12-0.7
Address of aulhor¢ed person (number and s6eet city, shate, and ZIP code)
Date (month. daY. Y��