HomeMy WebLinkAboutMortgage_Morris STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Count Township
z,� FOR DEDUCTION FROM ASSESSED VALUATION
Stile Fomn 437 (R73/1416 .
S; O Prescribed by Department of Local Government Finance
INSTRUCTIONS: �� 1 n17
To be filed in person or by mall • Fern Illiid with:
Firing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Audrtor or County Recorder of the county where the property is !1 w ,-: ..nor ,
located on or before January 5 of the immediate ly succeeding calendar year. ,. '• r 1/'�!TA' Recorder
2) Mobile/Manufactured Homes not assessed as Real Property.Must file with the County Auditor of l 4'ght r 01 NY A a
wham the properly is located during the twelve(12)months before Mandy 31 of each year the deduction is sou :'
See reverse side for additional instructions and qualifications.
t(owner or contract buyer-see restrictions on reverse side) •
Taxing D' Key number/legal description Record number a number
Q ra .0 1g -tic - ra,3 -ana_S&T- bA? / 1 35'17
Assessed value of real property as of Mortgage/Contract indebtedness repaid as of - Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
ss
a ssmwddab,current year aesaned date,current year date of application legal or equdable owner?
I db b a a Nres ❑ No
C 110,what is his I her exact share of interest? indicate' If owned withsomeone other than spouse,in aate with whom `
If name on record is different than that of applicant,indicate below. ts the properly in question:Annaupaylly Assessed
Teal Property ❑
Mobile Horne Assessed )
Nam of mortgagee or contract seller
W^e h e DO \ $r ,?0.--,.- -- •
Address of mortgagee or contract seller( ' berand street,city,state.and ZIP code)
•
Name of assignee or other owner or holder of mortgage ' - —
Address of assignee(number and sheet crly,state,and ZIP codi ' //1\1
Drawer NO (✓�lw`
Does applicant own property in any If yes,what rnrmtyt - tested If yes,state amount of deduction
other county in trhd ? ❑Yes 0 N
- Card NO. 35-9-)-- DNo _
A person is not entitled to this deduction unless the parse tebtedness that is recorded in the county
recorder's office(including any home equity tine of credit; &-e 5—II— 'basis for the deduction. . .
Deduction approved in the amount of:
C•.J•'I _
20 20 20 20 20 20 20
Signature of County Amino( County Date(month,day,yea)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner t contract buyer of the aforementioned property on date application is filed.
( ..„. Date(north,day.year)
r address of 1372 r -4 el 17
pfiGm(numbs and street city,state,and ZIP e)
authorized by duty executed Power of or by IC 6-1. -12-0.7 y Date(month,day,yea)
Address of authored person (number and street,city,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.