HomeMy WebLinkAboutMortgage_Sheldon� R�' : STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE:'^
f-� . � FOR DEDUCTION FROM ASSESSED VALUATION
�, ,v Stat2 Form 437W (R / 12-99)
Presaibed by Stale Board of Tax Commissioners
�
Instructions for filing:
To be filed in person or by mail with the County Auditor of the county where the property is
located during the 12 months before May 11 of the year fhe dedudion is to be effective. See
reverse side for additional instructions and qualifications. �
FORM 5
(owner
District
see
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share of interest?
If name on
tions on revers side) ^ n
��� CLC(%1�L l..L l� ti
Key number / legal description
/s-d o3s-o�
Mortgage ! Contract ihdebtedness unpaid as o
March 1, current year -
than that of applicant, indicate
of mortgagee or contract seller
Address of mortgagee or contracl seller (number and stieet, city,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and stieet, city, state, ZIP code)
APR 2 3 2001
Record
Page number 3Da �
f Is the applicant the sole legal or equitable
, ownef� ❑ Yes ❑ No
owned with someone other than spouse, indicate with whom.
ZIP
O� -�/
Does applicant own real property in any If yes, what counfy? What Taxing District? Has this deduclion been requested on
other county in Indiana? property for current yeaR� YesO No
PROPERTY TAX ASSESSMENT BOARD OF APPEALS
Deduction approved in the amount
20�'� I 20Qj• 03
200 N- I 20
� �-��- 61 I ��� I'��e�'"�"I �
Signature C�S� Seaetary of PTABOA
�
20
Date
20 !� /%
I/ We certify under the penalty of perjury lhat the above and foregoing information is true and corred and that the appiicants was / were
� resident of Indiana and owner of ihe aforementioned property on March 1, 20
��iignature (owne� ame) �:L����E�LO�'� Person authorized by duly executed Power of Ariomey
I � G or by IC 6-1.1-12-.07
1�9!
TIAddress of authorized person
0