HomeMy WebLinkAboutMortgage_Schurter •
!_.
A: :
STATEMENT DEDUCTION MORTGAGE S ES OR CONTRACT INDEBTEDNESS ■ �r Year
FOR DEDUCTION FROM ASSESSED VALUATION-
�� State Form G3709(R71/rw)
Prescribed by Department of Local Govertlnlem Finance
if s,R
INSTRUCTIONS:
To be filed in person or by mad with the County Auditor or County Recorder of the county where the property is locat=tj F-- ':./
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. Wr 1^lr •unry Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(0)BSOtii C O UN m �+�19 4 (�
before March 31 of each year the deduction is sought er
See reverse side for additional instructions and qualifications.
Appfimnt(_ ownerot_S> CbI t-see'lresarJions on, eW side) r� 1-D Ca_.4— I. 2 r�ty7-j Key Li/legal description lN� Record number PIV\e number
er 11 - An- aa3 3 (oS - aoCD ?U 13 iIll
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Match 1.urea year March 1,wrrent year data of application legal or equitable owner?
'69 5 oa [ Yes El NO
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
Motile Houle(IC 6-1.1-7)
of mortgagee or contract seller
•
Address of mortgagee or contract seller(number and street dry,state,and ZIP code)
_ -
Name of assignee or other owner or holder of mortgage - !________
Address of assignee(number and street,city slate,and ZIP code) Drawer NO p13
Toes applicant own property in any other If yes,what county? Ma U -
muntyinlrldara? ❑ Yes Ito m Card NO, 3/ / g 7 No
COUNTY AUD.._.. .
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
owner I contract buyer of the aforementioned property on data application is filed.
(o h //)� Date(mouth,day,Years I
'�'d t address f Sporran( mbar and street.a1y,slate,and ZIP code)
(/ i N. /o a. D s,-4 l'..i /v d6O
Person by duly executed Power of Attorney or by IC 6.1.1-12-0.7' ' r Date(month,day,year) .
Address of authorised person (number and street city,a and ZIP code)