HomeMy WebLinkAboutMortgage_Williams (10)�
Farm 5 ReviaM 19B1 ^� Filivg Pee fl-00
Prtx�ribed by the Sute Bm*d of Tea Commieeiovm O\ \( A
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' CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS
TO BE FILED IN PERSON OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER WITH THE COUNTY AUDITOR
�QN WHICH THE PROPERTY IS LOCATED) BETWEEN MARCH 1 AND MAY 10, INCLUSNE �
(6-1.1-12•1 THROUGH 6-1.1-12-8) .
°'QUALIFICATIONS ON BACK••' . O � O
I, (We)
_/}����J`�1.()l.J / _
ATE OF INDIAIyt4�� 'm r�\� COUNTY, ss:
Nyr �pu- `L 1`.) "I ' I W
certify that I, (We) was/were
statement is made for the pc
Legal Description/or Key A`umber
�tvu. nnate� Q*�
resident(s) of the State of Indiana and owner(s) of real property on March 1, 19 �(_ and that this
of obtaining a deduction &om lhat real property located in Taxing District (City, Towq Towaship)
Q��� �,
Name on property tax recards if different from above?
Are you the sole legal or equitable owner of the real estate? Yes Ido
Described to wiL
a
��- �a 9�
If no, what is your exact share o( interest in it?
Assessed value of real estate as of March 1, current yeaz I� �� °� oa O �" � aO
Amount of Mortgage or Contract [ndebtedness unpaid as of March 1, current year S '�� ��
Mortgage or Contract
Name and address of mortgagee or contract seller
County Recorder's Office, Record No. � Page 1�L�.
Do you know if there is any assignee or bona fide owner or holder of the mortgage or rnntract? Yes
what is the name and residence?
No If yes,
o� /
fJ
Does the owner of the above. described real property own real property in any other County in the State of Indiana?
� No I �es, what County and Taxing District?
Has this deduction been requested on that property for the wrrent year? Yes No
�o�Ml��o,�� 1987
.�
APPROVED IN AMOUNT OF $
REMARKS
OP BOARD
G ay_ a�,���
�p$ 09
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��a Pr�-a� a-- r b o r
4�^ �' � 'See False Statement Penalty Below ^ � Q
V! ���� � 'pN'\'ER'S FUIL \AMEI �r
�'�D� /� °
�PER50\ AOl'FIORIZE BS DULY E%EClfl'ED PoN'ER OF ATTORYEY)
���/// k y� � f,�,;�., S,5-��i`
� p'1 A�y �FULL A£SIOE\CE ADDR�SS OF OR'YER — MUST BE GIVE\I
� u /�
' o�%- 02 . �. �M�w�ie+.�.
�AUDRE55 OF AVfHO D PERSON)