HomeMy WebLinkAboutMortgage_Schmitt (12)- �'.
STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 637W (RS / a-03)
Prescribed by DepaRmem of Loral Gtivemment Finance
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INSTRUCTIONS:
To be filed in person or 6y mail with the County Auditor o! the county whe�e the property is located. � n: � O l
Filing Dates: 1) Real Property: Dunng the 12 months belore May 1 f o/ the year the deduction is to be�e�lecthe. 2��7
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the ded/uc,tion is to be effective.
See reverse side for additional insWctions and qual�cations. _ ����� � ��� Y� ��
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or c�prract buy�- see restnctidAs on reverse
Taxing Disirid �
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Assessed value of real property as of
March 1, currenl year .
If no, what is his / her exact share of interesl?
Key number / legal description � Record number
O/ i � ���� _ � Page number � / (�
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Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year ownef? ❑ Yes ❑ No
If name on rewrd is different than that of applicanl, indicate below:
�me of mortgagee or contract seller n
- �V/Z���t� �/I
Address of mortgagee or contrad seller (number and sfieet, city, s
UUV I
If owned with someone olher than spouse, indicate with whom.
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ?�? code)�__
Does applicant own property in any other I If yes, wh
counry in Indiana?
Deduction approved in the amount of:
20 20 �
Signature
Is the property in question:
❑�Real PropeAy ❑ Mobile Home QC 61.1
Drawer NO..a -- ---
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c�o�' ' 7:3�9. ......
,a�o' •
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20 O�/ 20 _�� 20 � Y
P P P
County Auditor
as this deduction been requested on
�operty for current yea(? � Yes ❑ No
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Date
20
I We certiy under the penalty of perjury that the above and foregoing information is true and coned and thal lhe applicants was / were
1resident of Indiana and owner of the aforementioned property on March 1, 20
(owners full
address of
Person authorized by duly executed Power of Atlorney
or by IC 6-1.1-12-.07