HomeMy WebLinkAboutMortgage_Schafer t„�, . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year _
f t;; FOR DEDUCTION FROM ASSESSED VALUATION
:i„-• f' Slate Porto by De artm/t of L FILED
Slate or by 709(R lent of Local Government Finance
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the F
Filing Dates: 1) Real Property:Must file during the sought ty property rs located.JUN 1
2) Mobile/Manufactured Homes not assessed as Real Property: is d County Auditor
roperly:Must file during the twelve(12)months
before March 31 of each year the deduction is sought. - , — - • -emrder
See reverse side for additional instructions and qualifications. '� �!
Apt/want(ownet«l see frictions on reverse sid '�O ' GItl501`I COUNTY AUDITOR
Tariig pimict 1 -05-517-09c2- � — 0004%-01/7 R I I•�ScR
Assessed alee'af real property as of Mortgage/Canna iMebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,assent year Mardi 1 cart year date of application legal or equitable owner?
'.3 O(atn) ❑ Yes 0 N
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below. Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(1C 6-1.1-7)
Name of mortgagee or contract seller ,v ,
Address of mortgagee or contract safer(number and Antinsei2t.„
t e,and ZIP code) /��_(/_�Jn`,
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code)
Dees applicant own property in any other If yes,what county? - What Taxing District? Has this deduction been requested on property
county in Indiana? ❑ Yes ❑ No for current year?
❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of
20 20 20 20 20 20 20
Signature of County Auditor • County Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
er/contact buyer of the aforementioned property on date application is filed.
.weerS a Date(month,day,year)
lr /.-.. //
us resident address o a•• 7 (nu ••r. state, L )
(0sQ6 ti '' r . � a..9>, 4766
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day year)
Address of autrud person (number and street city a and ZIP code)