HomeMy WebLinkAboutMortgage_Trotter STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS in Tranship Year
'n FOR DEDUCTION FROM ASSESSED VALUATION I ` P
i,-�� State Faro 437 (R13/10-15) Fille 11
Prescribed by Department of Local Government Finance
INSTRUCTIONS: SEP 5 2017 File Mart
To be Red in person or by mad. Form filed with:
Filing Dates: 1) Real Property Must be completed and dated in the calendar year for which the deduction is ht.
Must be filed orpostmariced with the County Auditor or County Recorder of the county where( e to ❑ County Auditor ,
located on or before January 5 of the immediately succeeding calendar year. nn
2) Mobile/Manufactured Homes not assessed as Real Property.Must file with the Ccei?Rldlforatt14.thflt!D ITt)F!" Recorder
where the property is located dung the twelve(12)months before March 31 of each year the deduction is sought
See reverse side for additional instructions and qualifications.
April • - or cavrtract buyer- reverse side)
V.4.,'islia Key number/legal description C`' > Record number Page number
. a6-i8- 36 - Soo -cook . o6 - oo& y ;t6 ( 7 3506
_.value drawl pmpnriy as of
Mortgage/Contract bdebfedness unpaid as of - Mortgage!Contract indebtedness unpaid as of is the applicant the sole
assessment dale.anent year assessment date,anent year date of a{plicati—on{n legal or equitable owner?i0 n
If no,what is his/her exact share of interest? If owned wwith someone orlrel than n ❑ Yes ❑ No
spouse.indicate with whom
If name on rend is different than that of applicant,indicate below Is the property in question:Annuafy Assessed
❑ Real Property ❑ Annually�Assessed
Mobile 1.7-7)
Nam of mortgagee or amtrd a seller _ FI
Address of um or coMad seller(number and street city,state,and ZIP code) -
-7—R0 j f Jc8-EP/1 e
Name of assignee or other owner or holder of mortgage ' r -T RIZd i-1 L
of assignee(number and street state,and ZIP code) '
X.0 90 t0/7 35cn -
Does own property N any If yes,what county? What Taxing District? this k
in Indiana? ❑Yes ❑No anent year! 64a" _
A person is not crated to this deduction unless the person has a balance on the person's mortgage or contract indebtedness us..—.___.
recorder's office(including any home equity fine ofaedit that is recorded in the county recorders office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of
20_ 20 20 20_ 20 20 20
Signature of County Auditor County Date(month,day,year) '
I I We certify under the penalty of perjury that the above and foregoing information is true and coned and that the applicant is a resident of Indiana and
owner!contract buyer of the aforementioned property on date application is filed.
Signature(owners tug name) Date(month,day:year)
,,,Full resident d of applicant(number and street city,state,and ZIP code)
/o„?S1 5 to✓.cez 1(.-tie /'AJASrA ' r, T..i 4/763
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-01 Date(month,day,year)
Address of authorized person (number and sheet city state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fee not to exceed$10,000.