HomeMy WebLinkAboutMortgage_Schmittler (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Countyp 7 ship Year
''`,_ ` FOR DEDUCTION FROM ASSESSED VALUATION jt
}-' State Fonn 43709(R13/1415)
�-- Presatbed by Department of Local Government Finance v Y
INSTRUCTIONS: De!ile Ma
To be filed in person or by mail. filefiled with.
Filing Dates: 1) Real Properly Must be completed and dated in the calendar year for which the deduction is sgljyht 4 t�
Must be filed or postmarked with the County Auditor or County Recorder of the county where Efl0So•- i. /county Auditor
located on or before January 5 of the immediately succeeding calendar year. .!� A County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of theNcrrlkA,�17.),.--.7-
where the properly is located during the twelve(12)months before Mardi 31 of each year the deduction is sougnr.Ty -�
See reverse side for additional instructions and qualifications. AVO/l
O
Apples t . er orco tract buyer res:fionsaverse side) -) v / R
{{{�c p�1 �� Ly :.7YJAJ/�y_mber C�JA-1(,,{,//.�{/a.C(�/ /�� 5/(JL /f ��/
fi �' •. ��//hC/�Cfl� .! %(Ll t /–/ �./o ` I COO, U �/ Vr�6 Recordn P"ag�11yq�lost/
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mort gage I Contract Ind tedness unpaid as of Is the applicant the sole •
assessment date,anent year assessment date,current year this of appGcatton //n/ I legal or equitable owner?
UXY �G2h 0 1 ❑ Yes ❑ 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 property in question:Annually Assessed
Real Properly ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller �//,�J//y//J�/ r \f�///]/,a
L) lit"/ _' . / C�/)�� l/)i° e
Address of mortgagee or contract seller( tuber and street city,state.and 4...e)
Name of assignee or other owner or holder of mortgage /l / ,,�yy ///y/�q//� �5�/G/�� �j
Address of assignee(number and street 0/Ii,state,and ZIP code) Q/y^)//JD!z frJ tax) / // v •
Does applicant awn property in any If yes,what county? What Taxing District? Has this deduction been reques If yes,state amount of deduction
other county , property for
in Indiana? =rent❑No rent year? ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's offaz)that is the basis for the deduction.
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 ' y t /• . diana and
owner I contract buyer of the aforementioned property on date application is filed. ry .�,
Sig' furl pa e� r/^.��,'� ^�
/) DWI'
pia resident address of applicant(number and street,illy,state,and ZIP code) )) --7 f�7
rCd d. f/9S7V lEw 17 F"/r7 eR A..•CR / /.v `7-)' Ilti-4 t I
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
Address of authorized person (number and street city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a ha/f years and a fine not to exceed$10,000. •