HomeMy WebLinkAboutMortgage_Greubel (6)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S � Sbte Fortn 437W (RS / 4-03) � � � ` \
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� Prescribed by Department oi Local Govemment Financa '
�NSrRUCnoNS: MAR v 3 ZOOIe Mark
To be filed in person or by mail with the County Auditor of the counry where the property is located.
Filing Dates: 1) Real Property: During the 12 months before May 11 oI tbe year the deduction�s to 6e e8e�ive. �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2�Iale`yeartl�eideduction,is_to be e8ective.
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See reverse side for addiUonal instructions and qualifrcations.
Appticant (o ner or contracf uy - see res tions on roverse side
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Taxin Districl ey number / legal descnption Record number .�_/D U/
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�{-�39�-� Pagenumber
Assessed value oi real property as of Mortgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equitable
March t, current year March 1, current year owneR es ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is l�operty in question:
Real Property ❑ Modle Home (IC Cr1.1-�
�me of mortgagee or contrad selier �/
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Address of mortgagee or contracl seller (number and stieet, city, state, ZIP "
Name of assignee or other owner or holder of mortgage — - --
Address of assignee (numberand street, city, state, ZlPcode) Dra�r'eC �TO ...................
Does applicant own property in any other If yes, what counry? ti Card NO . ..................... � requested on
county in Indiana? R� Yes� No
C/ � / li" / C� /
couNTVa�_.. _..
Deduction approved in the amounl of:
20 20 O� 20 �� 20 �' � 20 20 20
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Signature County Audftor Date
/ We certiy under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners (ull name) Person authorized by duly executed Power of Attomey
� or by IC 6-1.1-12-.07
FulJ,res� nt a ess of�plipnt Address of authorized person
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