HomeMy WebLinkAboutMortgage_Portee.•�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun To Year
r,. � FOR DEDUCTION FROM ASSESSED VALUATION �
s•
. ' State Pam 437W (RB! 2-07)
°�;. '� Presaibed by Department of Local Govemment Finance
iNSrRUCnoNS: MAR 0 9F�0��
To be filed in person or by mail wdh the County Auditor o7 fhe county where Ne property is located. -
Filing Dates: 7) Real Property: During the 72 months be/ore June 11 0l fhe year the deduction is to be eflecfive. /L�!
2J Mobile Homes assessed under IC 6-1J-7: Between January 15 and Maich 2 of the year the deducGo�jo.i�p Ai/6iLr8.
See reverse side for a itional insGucpons and q ations. (/ v
SON COUNTY AUDITOA
Applicant(owner r u e-s e �"ons " e) �
DisUic7 Ke number / I al desrnplion Remid n Page number
�• - -.o o.�. c�u�6- a �' 6io
Assessed value of real popsy as of March 7, aurent y�r Morigage I ConUac4 indeWedness unpaid as of March 1, Is the applicant the sde legal or equitade owne(1
arrentyear`��/ �
❑Yes ❑ No
whai is his / her exact share
If name on recwd is drf(eren� Uan Nat of applicant, indipte below:
Name of rtwrtgagee or coniract seller
Address of rtwrtgagee w wn�ract seller (numberan0 sVeet. tlty. stafe,
Name oi assignee w other owrrer or hdder of mwtgage
Atldress of assigriee (nam6er and slreef, city, stafe. and Z/P aode)
Does applicanl own property in any other If yes, whal counry? Whal
counry in Indiana?
❑Yes ❑ No
with someone olher than spouse, iMifate with whom.
Is ihe property in 9uestion:
❑ Real PropeAy ❑ Mobile Hane (IC 61.1-7)
uestetl on property
❑ Yes ❑ No
COUNTY AUDITOR
Deducfion appmved in lhe amount of:
20 20 20 _ 20 20 20 20 _
Signature of Counry Audilnr Counry Date (monfh, tlay, yearJ
�! We certify under lhe penalty of perjury tt�at the above and foregoing infortnation is We and correct and that the applicants was ! were a resident ot
Indiana and owner of the aforemen6oned property on March i, 20
Signa�ure (o eYS hAl name) Date (month, day, yea�
resident addres of �canl (num6er and et. cdy. sfate. a ZIP code) �
1
Person authonzed by du exeated Power of iwney or by IC 61.142-.07 Dale (mmth, day, yea�
Address of aWhorized person (numberarM sbeeL dty. sfate, aM ZIP code)