HomeMy WebLinkAboutMortgage_Cargal�vi �` y STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION hip Year
J State Form 437W (R6/ 5-06)
IN�
� Presaibed by Depanment of Loral Grnemment Finance
FEB 2 1 2008
INSTRUCTIONS: File Mark
To be filed in person or by mail with the County Auditor of the county where the p�operty is located.�—pr�,�, �f
Filing Dates: 1) Real Property: Dunng the 12 months 6e(oie June I1 0( the year the deducUon is to be efl�tive.�
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2@d�l��'i�A41i'��dG�i��'o be elfective.
See �everse side for additional instructions and qualffications.
(owner or
Taxing District
see rest 'ction reverse side)
Key number / I gal de
�ao iy-�n�. �
Assessed value of r� property as of
March 1, current year
If no, what is his / her exact share of interesi?
name on record is different ihan that
of mortgagee or contrad seller
MoAgage / Contrad ii
March 1, current year
below:
Record
Page
unpaid as of I Is the applicant the sole legal or
ownef? 0 Yes ❑ No
I( owned with someone other than spouse, indicate with whom.
Address of mortgagee or contract seller (number and street, city, state, ZIP
Name of assignee or other owner or holdr.r.of mortaaae
of assignee (number and street
Does applipnl own property in any othei
county in Indiana?
Deduction approved in the amounl of:
20�� 20 Q� 20
P P � �
Signature
Drawer NO. �WQ.:..���
Card NO . ................:....
COUNTY AUDITOR
20
County Auditor
�
Is the property in question:
❑ Real Property ❑ Mobile Home (IC 61.
Has this dedudion been requested on
property for cunent year? Q Ye50 No
20
Date
20
certify under the penalty of perjury that the above and foregoing information is true and corcect and thal the applicants was / were
lenl of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person