HomeMy WebLinkAboutMortgage_Schneider STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court I nshie I Year
FOR DEDUCTION FROM ASSESSED VALUATION y l
S ' State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: , * . +. I I ■
To be filed in person or by mail. I e
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. Cou Auditor
Must be filed with the County Auditor or County Recorder of the county where the property is located In
on or before January 5 of the immediately succeeding calendar year. .? Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor GyBSON • _ . .
county where the property is located during the twelve(12)months before March 31 of each year the • 5 ' -
deduction is sought.
See reverse side for additional instructions and qualifications.
Apr nt(owner or contract buyer-see trans on reverse fide)
J �chru Y-
Taain xin istrict Key number I legal description Mufti Pagyr
,2!0-1 P-. -Yof-000.045-004 / l//7(/U I
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mo age/Contract indebtedness unpaid as of Is the applicant the sole
March 1.current Cu year March 1,current year date of application legal or equitable owner?
p� 3o d r7iicel aces 0 N
If no,what is his/her exact share of interest? If owned with someone other Ulan spouse,indicate with whom
If name on record is different than that of applicant.indicate below:
nvroperty in question:Annually Assessed
aii Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of gopttgagee or contact sel er
Address of mortgagee or contract for(number and s f.cry,state,and ZIP code)
5001 1 -rh • � � (JhC LA4Jz Di WSda7
Name of assignee or other er or r of mortgage
Address of assignee(number and street.city,state,and ZIP code)
Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ Yes ❑ No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20_ 20
Signature of County Auditor County I 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
v owner/contract buyer of the afore ention property on date application is filed.
(owner j f I name) -'�`/`/C\ I Date(m t day,year)
g.Full resident address of appli,ar I(number and street, ty,star .and Z code ��
513 t/U ST/cJ US" tlU t� �(
(Person authorized by duty executed Power of Anomey or by IC 6-1.1-12-0.7 I Date(month.day,year)
Address of authorized person (number and street,city,state,and ZIP code)