HomeMy WebLinkAboutMortgage_Lance (2)�;�.;� : �a
Presrnb i br R�e Smu� Paard o(Ta. Cammiss:aners L
CERTIFICATE OF MORTGAGE OR COATROACT INDEBTEDNESS
TO BE FILED IN PERSON OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER WITH THE CC
pN R'HICH THE PROPERTY IS LOCATED) BETR'EEN MARCH 1 AND MAY ]0, INC SI�
(61.1-12-1 THROUGH 6-1.1-12-8)
� � "•QUALIFICATIONS ON BACK`^ �
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STATE OF
COUNTY, ss:
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ceRify that I, (R`e) was/were legal resident(s) of [he S[ate of Indiana and owner(s) of rea] property on Diarch 1, 19 � and that this
statemen[ is made tor the purpose of obtaining a deduction from that real property located in Taxing District (City, Town, Township)
Described to wit:
Legal Description/or Key Number
� Name on property tax recoids if different from above? °
z I��
A � MAY 1 p 1990
z Are you the sole lega] or equitable owner of the real estate? Yes ��
r-r C��J/�y��
�If no, what is your exact share of_interest in it? ���� -"�� ���
O / `�/'� /� AUbtTOFt "a`'�
� Assessed value of real estate as of March I, cursent year `��x/ -'� ��/
� Amount of Morlgage or Contract IndebItIedness unpaid as oC March 1, wrrent year S I�� �0 v
, DlortgaRe or Contract recorded ✓�� County Rernrder's Office, Record Na. � Page `�
�. Name and address of mortgagee or contract seller ��+-��`�"�''� !/ �-^�'�-�` )
� Do you know �if there is any assignee or bona.fide owner or hotder of the mortgage or mntract? Yes No if yes,
Qwhat is the name and residence? .
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z Does the owner ot the above described real property own real property in any other County in the State of Indiana?
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(� Yes No If yes, w•hat County and Taxing District? �
� ado�-� ,�`��
Q Has this deduction been requested on that property for the wrzent year? Yes �,No
C/i Amount Allowed Q�3 �-�d v
F 6"���°� c( �'D� - �oo
,Z COUNTY BOARD OF REVIEW ¢ •See False Stacement Penalty Below �i� �0�
�,,, ACTION ��I y �L-
(.W..i APPROVED IN AMOUNT OF $ a6s�� � I ��t`� �`� ���U �
� � f� � �O '�ER'S FULL �AME)
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3 w REMARKS
O• /, IPER50� AI/TFiORIZED Bl" DULY E%ECIIfED PoWER OF ATTOR.\EY)
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�FULL RESI�ENCE ADDRF55 OF OW\ER — MUST BE GIVE\)
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SECftETARY' OF BOARO - IADDRESS OF AUTHORIZED PERSOV
DATE
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