HomeMy WebLinkAboutMortgage_Mowrer STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
" -41 FOR DEDUCTION FROM ASSESSED VALUATION �r
:- Stale Form C37�(R13l1ais)
—% Prescnbed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by marl ith:
Filing Dates: 1) Real Property:Must be completed and dated In the calendar year for which the deduction is sought. DEC I)E C LTV dF0 f'�d
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year.
2) Mobile/Manufactured Homes not assessed as Real Property.Must file with the County Auditor of the coalipirciiiitrintY Recorder
where the properly is bcated during the twelve(12)months before Mardi 31 of each year the dederIMIONWYOUN I Y AUDITOR
See reverse '.e for additional instructions and quaf •-i.
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T. :: . . Key I legal description Page r
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value property aiof Mortgage I Contrail indebtedness unpaid as of • Mortgage!Contact indebtedness unpaid as of is the applicant the sole
dam assessment date,anent year date of appfxation legal or able owner?
( �� � ❑ Yes ❑ No
tf no,what is his I her exact share of interest? If owned withsomeone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is property in question:Annually Assessed
Real Property ❑ Annually Assessed
////y Mobie Home(tC 6-1.1-7)
Nacre of mortgage or contract safer 1 -7 Ct_�x"L t _i�
Address of mortgagee or contact seller(number and street,city,state,and ZIP code)
of assignee or other owner or holder of mortgage
� ' •
�i ,1/// ��//'�/ Q �1
of assignee(nu berg and rAV0.€ ,oP code) y` /v 2e —i /a ! • 7/�//�
Does applicant own property in any elf" A,.mrmty? . at Taxing District? Has He deduction been requested If yes,state amount of deduction
other in Indiana? ❑Yes ❑No - aenamemtyear?r ❑Yes 0 N
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity fine of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR • • '
Deduction approved in the amount at
•
20 20 20 20 20 — —1 __ _ r
Signature of County Auditor _- - - _- .County ((nn)' (.. —
/We certify under the penalty of perjury that the above and foregoing information is true and ce D 1.1\1'e 1' \O.... V!` ,... —
owner!contract buyer of the aforementioned property on date application is fled. / JO q
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S y-Owl fi� ) r')rd NO. V
Fu em a- of applicant(nu se- and street,city,state,and ZIP code) V\ a)
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Person authorized by duly executed Power of Attorney or by IC 61.1-12-07 Date(month,day,year)
Address of authorized person (number and street,aTy,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000. - - _ _