HomeMy WebLinkAboutMortgage_Lott,.a�' y STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�i' � FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
. . N� �� State Form 437W (R6 / 5-06)
� Prescnbed by Departmenl of Local Govemment Finance /
JAN 2 6 2007
INSTRUCTIONS: File Mark
To be filed in person or by mail with the County Auditor of the county where the p�operty is located. �-,,�
Filing Dates: 1) Real Property_ Dunng the 12 months before ,lune 11 of the year the deduction is to be e/tecuve• �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of th�e��e� t���Td�io�J$ fi� e8ective.
5
See reverse side for additiona/ instiuctions and qual�cations.
(owner or contract buyer - see
Distrid
reverse side)
Key number / le
;�
' ' I Record number
number
• � �J 'C.�
Assessed v e of rea roperty as of MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or f
March 1, current year March 1, current year owneR �s ❑ No
_ t�9�
li no, what is his / her exad share of interest? f owned with someone other than spouse, indicate with whom.
� —1 -� oo-oo S-o
If name on record is di erent than that of applicant, indicate below: Is the property in question:
❑ Mobile Home (IC G7.
me of mortgagee orlcontract seller �
' -T r U�Y�'i��c{2,i�^ �
Address of gage or contrad selier (number and street, ary, s�a�e, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this deduction been requested on
county in Indiana? - ������*. �..�..-��mo�r.�o�n.O_vosO No
Drawer NO.Q. �.:. �% �.�...
COUNTY AUDITOR
Deduclion approved in the amount of:
20 � I 20 �
0
Signature
20 � 20 20
p
County Auditor
Card NO. —
..................... .
Date
We certify under the penalty of perjury lhat the above and foregoing information is true and corred and that ihe applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
_�
�
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person