HomeMy WebLinkAboutMortgage_LovelessForm.i Ik.ised 14?1
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Presmibed br tAe Stav tloard of Tax Comm�zs�oners
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' CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS
TO BE FtLED IN PERSON OR BY M.11L ItQ DUPLICATE EACH YEAR BY THE OR'NER WITH THE COUNTY AUDITOR
(IN WHICH THE PROPERTY IS LOCATED) BETR'EEN MARCH 1 AND MAY 1Q INCLUSIVE
� . (6-1.t-124 THROUGH 6-1142-8) ' �
'^QUALIFICATIONS ON BACK^•
��-ly -o� -300 0� 5/8 �Ob n a e , �
STATE OF INDIANA
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COUNTY, ss:
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certify that I, (Ne) was/were legal resident(s) ot the State of Indiana and owner(s) of real property on March 1, 19 � and that this
statement is made for the purpose of obtaining a deductibn from that real property located in�Taxing District (City, Town, Township)
�—`� '"-" "" Described to wit:
Legal Description/or Key Number �.7� S C. � W 1- a- g a� � b fl�-
Name on property tac records if ditferent from above?
�
Are you the sole legal or equitable owner of the real estate? Yes
If no, what is your exact share of interest in it?
Assessed value of real estate as of March 1, current year
No
�a— �O/,� %
Amount of Mortgage or Contract. Indebtedness unpaid as of March 1, current year $ ��Qf °"� � ��
Dlortgage or Con[ract recorded � � County Recordei s Offic�e, R�ecord No. � Page �b��
Name and address of mortgagee or contract seller � ��^"" � `�"'-r" ���-�'"„'"°+
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Do you know if there is any assignee or bona £de owner or holder of the mortgage or mntract? Yes
what is the name and residence?
no If yes,
Does the owner of the above described real property own real property in any other Count�� iana?
Yes A'o If yes, what County and Taacing-District? - _
Has this deduction been requesced on that property for the wrrent year? Yes No NOV 0 8 1989
Amoynt Allowed
od
COUNTY BOARD OF REVIEW
ACTION
APPROVED I\ AMOUNT OF S�
REMARKS � tr'r �
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SECAETARY OF BOARD
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"'See Ealse StatemeM Pg'n21ty Ee�ow a�06.3 �
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�OWNER'S FUIL �AM �
�1 NSON AUTFIOftIZEU Bl' DULY EXECUTED PON'Eft OF ATICIR\EYI
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(FULL RFSIDER ADDR�SS OF OW\ER — MUSf BE GIVEN�
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. (ADURESS OF AUTHORIZED PElt50.Y)