HomeMy WebLinkAboutMortgage_Steinhart STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County t1 'FOR DEDUCTION FROM ASSESSED VALUATION
it State Form 93709(R11/6-09)
Prescribed by Department of Local Government Finance
File Mart
wS7RUC71ONS: CC F 7014
To be filed in person or by mad with the CountyAuditor or County Recorder of the county where the property is located. Foy Ned
With:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought /) Cou
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
See reverse side for additional instructions and qualifications. GIFSONCOUN-1Y TOP.
Applicant(owner or contras uyer-see rations on reverse side)( �`(y� �}(/�
Taxing s�-r 2 / i A. a N 6%, ,�� 1--� sc \\--& Page number
LdS�t�siK7slc �L- (3-ac., - aD0- dh (. .�A5i - 6O(- 1 ,.994
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1:anent year Mardi 1, year date of application legal or equitable crane?a current poses ❑ No
If no,what Is his l her exact share of interest? If owned with someone other than space,indicate with whom
If name on record is different than that of appfranl,indicate below `�Is I tee`property in question:Annually Assessed
E rteal Property ❑AnnuallyASsessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
( _� .
Address of ee or contract seller(number and street.city,state,and ZIP code) /
Name of assignee or other owner or holder of mortgage /O,r/{�1_i 0 •
Address of assignee(number and street,city,state,and ZIP code) / 516°��- g°1911�t/ �
Does applicant own property in any other If yes,what county? • Von au 01 ( yI . 461 94
vquested on property �
county in Indiana? r V 14 ❑ yes p-'No
❑ Yes ENO
coul 513rI{ a ,..e Deduman approved m the amount of: . f N 1
20 20 20 20 20 20 20_
Signature of County Auditor ' County Date(month,day,year)
I 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
■ /contract buyer of the aforementioned property on date application is filed. .
Sig owner's fiAranpw%ca Date(month,day,)ear)
• (/n, ad
Endent address of a t( m rand sheet,oly,stale,and ZIP code)
/00(, ) E 2c s cox/aid 04y 17,J X176 6 o
authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authored person (number and street,city,state,and ZIP code) •