HomeMy WebLinkAboutMortgage_Schmitt (8) sr I�cQ t STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township near;; FOR DEDUCTION FROM ASSESSED VALUATION I L t
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� State Form 43709(R71/609)
Pr scribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: • 1
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. ,
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. County A itor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months
before March 31 of each year the deduction is sought - rder
See reverse side far additional instructions and qualifications. GIB' - . . . e : _
AppGrant. (own9�o(mn�d&puyaire resent' ton reverse side)
Ta ' l7//1/ /1['^/j-�(r (�J/ Key number/legal descd Lion Renard number Page number
1‘..j.3-0V- Joe- aod,,536- as y o/3 At 47/
value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact'indebtedness unpaid as of Is the applicant the sole
t,army year Mardi 1.anon year data of application/ �'�/ legal or equitable owner?
If no,what is It/her exact share of interest? If owned with someone other spouse,�te with whom DYeS ❑ No
If name on record is afferent than that of applicant Indicate below. yea]the property in question:Annually Assessed
/' ��IR� ❑Annually ed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller /
Address of mortgagee or contract seller(number and ssteeet ciN�statte,and ZIP code) ///'''LLL
Name of assignee or other owner or holder of mortgage , / /� j n - //0
Address of assignee(number and street city state.and ZIP code) /.{/ �'�[/y- l
Does applicant own property in any other If yes,what county? • `what Taxing District? Has this deduction been requested on property
county in Indiana? ❑ No I for comet year? ❑ Yes ❑ No
❑ Yes //�'7
Deduction approved in dm annum of Drawer 1\iO �) r'✓/
20 20 20 L/..' [�i.... 20
Card 1'O. ... ..�•
Signature of Dimly Auditor .day,year)
I I We certify under the penalty of perjury that the above and foregoing imormauon rs true anu unieu am,Milt ule dpfm.ent is a resident of Indiana and
owner/contract bu r of the aforementioned property on date application is filed.
>..r5ig Fitt Date(month,day. ad
ya9y
1 Fut resident address of applicant(n ber and street city,state, ZIP code)
'T'
11110 S so E 1-f a o to s to , r N 1171039
Person authorized by dully executed Power o Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street city,stare.end ZIP code) .