Form D-37 - Notice Of Mortgage, Pledge, Or Purchase

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FORM D-37
STATE OF HAWAII — DEPARTMENT OF TAXATION
(REV. 2010)
NOTICE OF MORTGAGE, PLEDGE, OR PURCHASE
In accordance with section 231-33(e), Hawaii Revised Statutes, notice is hereby given of the following mortgage, pledge, or purchase
made or about to be made between the parties named below:
1.
Name and address of mortgagor, pledgor, or seller:
(Name)
(Firm or Business Name)
(Social Security Number)
(Hawaii Tax ID Number/Federal Employer ID Number)
(Mailing Address)
(Business Mailing Address)
(City)
(State)
(Postal/Zip Code)
(City)
(State)
(Postal/Zip Code)
(Home Phone Number)
(Business Phone Number)
(Business Phone Number)
2.
Name and address of mortgagee, pledgee, or purchaser:
(Name)
(Address or place of business)
3.
Kind of transaction (State whether mortgage, pledge, or purchase):
(Attach copy of instrument, if available)
4.
Amount of mortgage, pledge, or purchase price (if determined): $
5.
Date of mortgage, pledge, or purchase (if made):
(If recorded in the Bureau of Conveyances) Document No.:
6.
Description of property: (If additional space is needed, use a separate sheet, or sheets, and attach same to this notice.)
By:
(Mortgagee, Pledgee, or Purchaser)
Type or Print Name:
Phone Number:
Date:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
RECEIVED
Office of the Director of Taxation
Date:
Taxation District:
By:
Title:
Oahu District Office
Maui District Office
Hawaii District Office
Kauai District Office
P. O. Box 259
54 S. High Street #208
75 Aupuni Street #101
3060 Eiwa St. #105
Honolulu, Hawaii 96809-0259
Wailuku, Hawaii 96793-2198
Hilo, Hawaii 96720-4245
Lihue, Hawaii 96766-1889
(830 Punchbowl Street)
FORM D-37

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