HomeMy WebLinkAboutMortgage_Schroeder STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
-4r FOR DEDUCTION FROM ASSESSED VALUATION
1" State Form 43709(R13/10-15)
✓ Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed In person or by malt Form filed with:
Filing Oates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is 0 County Auditor
located on or before January 5 of the Immediately succeeding calendar year. 0 County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought.
Sae reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrklions on reverse side)
Schroeder, Galan T. and Schroeder, Shelby
Taxing District Key number/legal description R ry[)i_im�r PiBa� �'
Johnson 26-19-35-400-002.710-024 \—Y/�'/� `� c/C
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract Indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,ascent year date of application legal or equitable owner?
397,176.00 L•'I 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 the property in question:Annually Assessed
❑� Real Property •lit Assessed
-�{ ., • ?ome(IC 6-1.1-7)
Name rf man A or contract seBr ��p
German American Bank `Y1
Address of mortgagee or contract seller(number end street,city state,and ZIP coda) 2o\g
711 Main Street, Jasper IN 47546 P�6 21
Name of assignee or other owner or holder of mortgage
b t OR
Address of assignee(number and street,city state,and ZIP code) ,.;IN
P
At
Does applkant awn propertrtyy i ny If yes,what county? What Taxing District? Has this deduction been requestekg c3( S,sta a amount of deduction
other county on rent yrtyea? ,_.Ro
oIn er coo t ❑Yes No current year? ❑Yes UNo
A person is not entitled o th 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 recorders office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved In the amount of
20_ 20_ 20 20 20 20 20
Sig re f County Audlyf cy Court ' Date(month,day.year)
AA ri
We certify under the penalty of perjury thit the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
I d
er I contract buyer of the aforementioned property on date application is filed.
Signature conmef�yjull name r /) (� 4 v /'o / _ _ / _4/ Date(month,day,year)
Gill r.G/(-o�/�j .`G`I''/41 ,lJ\ it/ni//L)L�r.'f/)�/YY// 8/15/2019,year)
Full resident address of applicant(number and street,city state,and ZIP code)
4031 E. White Oak Lane, Haubstadt IN 4763
Person authored by duty executed Power of Attorney or by IC 6.1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state.end ZIP code)