HomeMy WebLinkAboutMortgage_Schenk^�3v STATEMENT OF MORTGAGE OR CONTRACT I N� Coun 7ownship Year
.,�_,_ - FOR DEDUCTION FROM ASSESSED VALUAT
' srace ram aa�os (R�i i s-0s>
,�+ � pr¢yr�ped Dy Department af Lad GoremmeM Fuianre
� FEB 13 2013 File Mark
wsrRUCnoNS:
To be filed in erson a b mad with the Coun Auditor or Coun Recortler ol the coun ere the ro F� m� �: �
P Y N N � P PertY is bcated.
Fifitg Dates: 7) Real Pmperty: Must file during the year for which Ne deduction is �� ��unry Auditor
2J Mo6Be / Manufactured Homes rrot assessed as Real Prope � Must (12) months Coun Reoorder
6etoreMarch3loleachyearMedeductioniss<uyht �18SONCOUNTYqUDITOR Ty
See reversa side /ar additional instruclfons and qualifiwtions.
MP��ioM+rerar�tractpvyu- rcs?+f�ligrsmreynr�ffie) I L %�,
Key number / le9al deuripG
� l�—//-/,� —
0.aessed rdue d real popettY as d
Ma�M 7. amPnt y�
It ra. what Is his I Mr e�l share ot interesi?
If name on fecwd
Name oi azsignee w othrJ owner
�� o�
4dehteC(ress unoaitl as of
seller (number aM sfree; rity, sNale, arW ZIP codej
slate,
property in any oNer
❑ Yes ❑ No
ction approved In Cre amount of.
20 _ 20 _
or CnmN nudr�r
Retard numjgr
J
unpaid a d Is Ne
�
sameorre otlrer Nan
ves u No
Is C�e OroGen1' in question: AnnuaM nssc4ea
Real Roperty � Nmually A55essed
hbdle Fiome QC 61.1-
— SC NEiV l< t G�1-(� .I f� -
V /� / /� A°nPrWeitY
es ❑ No
COl1NTYl.�__
20 20 20
20 _ 20 _
Date (++mrCh. daY• !'ea�
1/ We certify under the penalry af perjury that Ne above aM foregoing infortnation is true and cortect and that the applinnt is a resident of Indwia ard
own r I contracl buyer of fhe aforementioned property on date application is filed.
� (own s Ml name✓ i Date (monfh. daY. Yae�
sbee4 �1: �ta, aM LP codeJ
W
pejson (numberarM sbee; rity, state, and LP code)
Date (rtronfi.