HomeMy WebLinkAboutMortgage_Scott (8)`° rt�'' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�`-" = FOR DEDUCTION FROM ASSESSED VALUATION
S y Slate Form 437W jR4 / 1Q01)
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� Prescribea by Department ot Local Govemment Finance
INSTRUCTIONS�
Count Township Year
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To be �led in person or by mail with the County Auditor o/ the counfy where the property is located.
Filing Dates: 1) Rea/ Property: During the 12 months belore May 11 of fhe yea� the deduction is to 6e effective� 7 2�02
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0/ the year the deduction is to be ef/ective.
See reverse side (or additional instructions and quali�cations. �J//,�J
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Applicanl (own or cont ct bu er - s 2stnctions on reverse side)
Ta,xing'/Dis�trict Key number / legal description Record number �
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Assessed value oi real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole le al or equitable
March 1, curtent 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 other than spouse, indicate with whom.
If name on record is different lhan that of applicanl, indicate betow: Is the property in question:
❑ Real Property ❑ MQbile Home QC 61.1-�
ie of mortgagee or contraIX seller
ress of mortgagee or contrad seller (num er nd street, city, state, 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 Distric[? Has this dedudion been requested on
county in Indiana? property for current year?❑ Yes❑ No
COUNTY AUDITOR
Deducfion approved in the amount of:
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Sign ture County Auditor Date
Ne certify under the penalty of perjury that the above and foregoing informalion is true and corred and that the applicants was / were
;ident of Indiana and owner of the aforementioned property on March 1, 20
Sig ure (own rs full name) Person authorized by duly executed Power of Attorney
��w�(�Gu-��. , or by IC 6-1.1-12-.07
FuII resident address of applicant Address of authorized person
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