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EORMJAPPROVED BY STATE BOARD FOR THE CITY'OF'CARMW!,'1989,
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04/14/2004
James & Kathleen Gurzynski
12883 Andover Drive
Carmel, In 46033
CITY OF CARMEL
BARRETT LAW DIVISION
Barrett Number: 5
Resolution Number:
Parcel Number: 16- 10- 29- 04- 03- 019.000
Landowner ID: 259
NOTICE OF ASSESSMENT 11"1
DI(D1°4 1)‘/
Brookshire North Improvement District $580.00
The above amount is due in full without interest if paid by 5/10/2004. You may also choose to sign
the attached waiver agreeing to pay in 5 annual installements with interest (See attachment). Questions
regarding this Barrett Law assessment should be directed to the President of your homeowner's
association or the Carmel City Attorney (571- 2472).
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427
Barrett Number: 5
Resolution Number:
Parcel Number: 16- 10- 29- 04 -03- 019.000
Landowner ID: 259
Barret Law Installment Schedule
Year Principal Interest Total Payment Due Date
1 $ 102.89 $34.80 $1 37.69 05/10/2004
2 $109.06 $28.63 $1 37.69 05/10/2005
3 $115.61 $22.08 $137.69 05/10/2006
4 $122.54 $15.15 $137.69 05/10/2007
5 $1299 $7.79 $137.69 05/10/208
Make checks payable to: City of Carmel Barrett Fund
WAIVER OF PROPERTY OWNER
If you wish to make 5 annual installment payments, one -fifth of the assessment plus interest to the annual
due date will be charged (see chart above). If this is your choice, please sign the 'Waiver',
notarize signatures, and return in the enclosed self - addressed envelope with the first payment.
Signature:
Signature:
Installment notices to be mailed to:
Subscribed and sworn before me this
day of 20
PRINTED NAME OF NOTARY NOTARY'S SIGNATURE
COUNTY OF RESIDENCE
My Commission Expires
Make checks payable to: City of Carmel Barrett Fund
THLE N „01). SiC1
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CARU LiNJ 48033
li SgVINGS
NIOIp EDrOasit a
UTANAPQL�Sd�. ".- ..ihs?.t
04/14/2004
James & Kathleen Gurzynski
12883 Andover Drive
Carmel, In 46033
Barrett Number: 5
Resolution Number:
Parcel Number: 16- 10- 29- 04 -03- 019.000
Landowner ID: 259
NOTICE OF ASSESSMENT kpl°4 V i
Brookshire North Improvement District $580.00
The above amount is due in full without interest if paid by 5/10/2004. You may also choose to sign
the attached waiver agreeing to pay in 5 annual installements with interest (See attachment). Questions
regarding this Barrett Law assessment should be directed to the President of your homeowner's
association or the Carmel City Attorney (571- 2472).
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427