HomeMy WebLinkAboutMortgage_Will (3)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
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FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
-�� � w I Sfate Form 437W (RS / a-03)
r PrescriGed by Department ot Local Govemment finance �� � ti� ��
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�RUCTIONS: File Ma��u3
� ee filed in person or by mail with the County Auditor of fhe county where the property is located. U �� � y
Filing Dates: 1) Real Property: During the 12 months betore May 11 0/ the year fhe deduction is to 6e eflecfive.
2) Mo6ile Homes assessed underlC 6-1.1-7: Between January 15 and March 2 oI the year fhe deduction is to be eBectiv�
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See reverse side for additional inshuctions and qualifications. ��gSON COU�`T ti"�����T�F �
Of COlIj(7CI O WBF - SBC
side)
Key number � legal description I Record number �� 2
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O - v O{^� � Page number /�/� f�
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Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the� ole tegal or equitable
March 1, cunent year March 1�nent year owner? [�"Yes ❑ No
% �oa.
If no, what is his / her exact share of interest? If ovmed with someone other than spouse, indicate with whom.
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If name on record is different than that of applicant,
of mortgagee or contract seller
ot mortgagee or
, h�'� "��
�
��ql p'� araperty in question:
+ Property ❑ Mobile Home (IC 61.1-7)
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Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, ciry, state, ZlP code)
Does applicant own property in any other If yes, what counry? What Taxing District?
wunty in Indiana?
7'fi S G� �i 4J i 3 J-.3- �D COUNTY AUDITOR S�
Deduction
20
Signature
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amount
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P I r
County Auditor
Has this deduction been requested on
property for current year? ❑ Yes� No
20
�
20
I I We certify under the penalty of perjury that the above and foregoing infortnation is true and conect and that the applicants was / were
a resident of Indiana and owner of the aforementioned praperty on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
resident address of applicant Address of authorized person
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