HomeMy WebLinkAboutMortgage_Maurer (2)�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S J State Form 637W (R5 / 4-03) � j , _h�—�
�a� {! ��
� P2sai�etl by Depanment of Local Govemmeni Finance � � �� (! jJ
�....1'
JUN 92o0
INSTRUCTIONS: /� Ffe �ark
To be filed in person or by mail with the County Auditor o/ the county where the property is locaf .
Filing Dates: 1 J Real Property: During the 12 months be(ore May 11 0l fhe year the deductio � s��.be e/tective �� 0
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the�!eartlie,deductio �sdo'be eflective.
� tiu�:iU.: :
See reverse side tor additional instiuctions and qualifrcations.
Applicant (o r or contract buyer - s e restn
°VL
Taxing Distnd .
� QilCC�/
Assessed value of real property as f
March 1, current year
It no, what is his / her exact share of interest?
side)�
Key number / Iegai description / I Record number
� OD �
O/� , O/�' �a —(f Q Page number ����
Mortgage! Contrect indebtedness unpaid as of Is the aopliwnt the sole legal or equitable
March 1, wrrent ye2r � owner% ❑ Yes ❑ No
�� av v
If owned with someone other than soouse. indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in quesfion:
❑ Real Property ❑ Mobile Home (IC &1.1-�
�3me c! mortgagee or contract selier
Address of mortgagee or contract seller (n�an�v, ste" "O -
Name of assignee or other owner or holder o(:nortgage j�ra`�,et, Oq.� 'J�
. •'�l{�......
- --- C^
Address of assignee (numberand street, ciri. °;a!=, ZIP code) Card i\�0. , ��J 1 1
�a5 ............�(.....
Does applicant own property ir any ether I I' yes, vrhat courdy _ ��O �een requesfed on
county in Indiana? i � � pwpe��y � ... ........... year?❑ Yes� No
Deduction approved ir ihe amount of:
20 �,� 20
�
SignaWre
COUNTY AUDITOR
20 �'� I 2Q _Q$_ I 20 �`
� I P ! P
County Auditor
20
Date
�
' We certify under the penalty of perjury that the ahove and feregoing information is We and corred and that the applicants was / were
resident of Indiana and owner of the aforemer.iioned propert;� on March t, 20
(owners fuAname)
Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
authorized person