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HomeMy WebLinkAboutMortgage_McClure� � � �M� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS FOR DEDUCTION FROM ASSESSED VALUATION Stale Fwm 437p9 (RS / 4-03) Prescnbed Dy Deparimem of Local Govemment Finance INSTRUCTIONS: To be filed in person or by mail with the County Auditor o/ the county where the property is located. � �� r ��j 2���f Filing Dates: 1) Real Property: Dunng the 12 months belore May 11 0/ the year the deduction is to be e/(ecti e. 2) Mobile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 0l the year the /deduction is to be efiective. See reverse side for additional instructions and qualifications. � �! . � .�`✓!1� � - Gfajp•.�r.,��PTVyL'DITC� . Applicant (owner or contract buyer- see restrictions on reverse side) � Taxing Dislricf Key number / legal description Record number � PL_ __ O�(�I _ Q I/ CO �, DT Page number n� 'l.(Yv � '7 ro � � Y Assessed value of real property as of MoAgage / Contract indebtedness unpaid as of is fhe applicant the sole legal or equitable March 1, wrrent year March 1, current year ownef? ❑ Yes ❑ No D � Ii no, what is his ! her exact share of inierest? If owned with someone other than spouse, indicate with whom. If name on record is different lhan that of applicant, indicate below: Is the property in question: ❑ Real Properly ❑ Mobile Home QC 61.1-� "�me of mortgagee or contrad seller Address of mortgagee or contract seller (number an street, city, st e, ZIP Name of assignee or other owner or holder of mortgage Address of assignee (number and street, city, state, ZIP code) Does applicanl own property in any other If yes, what county? What Taxing District7 Has this deducfion been requested on counry in Indiana? property for wrrent year7 �] Yes � No COUNTY AUDITOR Deduction approved in the amount of: 20 � 20 20 �_ 20 _p �_ 20 20 20 � P Signature County Auditor Date �� We certiy under the penaliy of perjury that the above and foregoing information is lrue and corred and ihat lhe applicants was / were sident of Indiana and owner of lhe aforementioned property on March 1, 20 ` ure (owne�s lull name) Person authorized by duly executed Power of Attomey �Q� . „ or by IC 6-1.1-12-.07 �.c.cti�� Fu resi nt address t applicant Address of aulhorized person � �