HomeMy WebLinkAboutMortgage_BeadleSTATEMENT OF MORTGAGE OR CONTRACT INDI
FOR DEDUCTION FROM ASSESSED VALUATION
�. State Form 437W (RS / 4-03)
� Presaibed �y Departrm_r.l of Laal Govemment Finance
INSTRUCTIONS:
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To be filed in person or 6y mail with the County Auditor of the county where the property is located.
Filing Dates: 1 J Real Property: During the 12 months before May 11 of the year the deduction is to be�a(f,ectiv��
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the dedu n is to be ef(ective.
GIBSON COUNTY AUDITOR
See reverse side !or additional instnictions and qual�cations.
Applicant (o�r or contract 6uyer - see resfn 'ons on 2verse side)
Taxing Distrid ey number / legal description Record number Q�
/ � O\I �^ DOO ^�� "M Pagenumber qa
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Assessed valu real property as of Mortgage / ContraIX indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owneR ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone ather than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home (IC 61.1-�
�me of mortgagee or contract seller �
Address of mortgagee or wntrad seller (number and st2et, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand st2et, 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? property for current year?Q Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 �� 20 20 20 20 20 20
P � P
Signalure County Auditor Date
�' We certify under the penaity of perjury that the above and foregoing information is true and correcl and thal the applicants was / were
esideni of Indiana and owner of the aforementioned property on March 1, 20
i afure (owners I name) Person authorized by duly executed Power of Attomey
� or by IC 6-1.1-12-.07
resident address of applipnt Address of authorized person