HomeMy WebLinkAboutMortgage_RainsQ�rt•n t STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
il -" .. : POR DEDUCTION FROM ASSESSED VALUATION
"���� SUte Form 437W (Rd /10-01)
�� Prescribed Dy DepaNnent of Loral Government Finance
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INSTRUCTIONS:
To be filed in person or by mail witn the County Auditor ol the county whe2 the property is located.
Filing Dates: 1) Real PropeRy: During the 12 months befoie May 11 of the year the deduction is to 6e�N�tiielJ 20�3
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 of the year the ded/uction is to be eflective.
See reverse side lor addrtional inst�uctions and qualifications_ � `� C,1j /J �
i� (owner or contract buyer - see resMctions on reve�se side)
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Distrid Key number / legal description Record number
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Assessed value of real property s of MoAgage / Contract indebtedness unpaid as of
March 1, curtent year Ma 1, current year
If no, what is his / her exact share of interest?
If name on record is different than that
of mortgagee or contraG seller
Address of
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! >C^�ITOF.
is the apphcant �tne�° ie iegai or equnac
owne(? +L3"Yes ❑ No
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If owned with someone other than spouse, indicafe with whom.
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or coniract seller (number and street, city, state, ZIP
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Name of assignee or other owner or holdqt of mortgage
Address o( assignee (number and street, ciry, state,
is tne property in quesuon:
❑ Real Property ❑ Mobile Home (IC &1.1
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Does applicant own property in any olher If yes, what counry? I What Taxing District? Ha5 IhIS tlEtluCUOn bBBO f0qU05te0 Or
counry in Indiana? property for current year?�] Yes� N
Deduction approved in the amount
20C� _ � 20(Z�
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Signature
COUNTY AUDITOR
20 O� 20 Q
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Couniy Auditor
20 � � 20
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20
�/ We certify under the penalty of perjury thal the above and foregoing infortnation is true and correct and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Signatur (owner' full name Person authorized by duly executed Power of Attorney
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lt'7b. "7�% IAddress of authorized person
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