HomeMy WebLinkAboutMortgage_GreubelI r��
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Peescnbed by �i,e Su'e Boerd af Te: Commissioners '
CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS .
TO BE' FILED IN PF.RSON OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER WITH THE COUNTY AUDITOR
(IN WHICH THE PROPERTY IS I.00ATED) BETWEEN MARCH 1 AND MAY 10, INCLUSIVE
(6-1.1-12-1 THROUGH 6-1.142-8) '
'•'QUALIFICATIO\S ON BACK'••
STATE OF
I, (\Ve)
. ` �
A COUNTY, ss:
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certify that I, (Ne) was/were legal resident(s) of the State of Indiana and owner(s) of real property on.i�farch 1, 19 �SL and that this
statement is made for the purpose o( o�taining a deduction from that real property located in Taxing District (City, Town, Township)
Legal Description/or Key Number
Name on property taac records if difterent from above?
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A
z Are you [he sole legal or equitable owner of the real estate? Yes
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GQ
N If nq what is your exact share of interest in it?
Mi
� Assessed value of real estate as of March 1, current year
No
�
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Described to wiL
� � Amount of Mortgage or Contract [ndebtedness unpaid as ot 0larch 1, current year S ��1•O v����0
�`� �1ortga�e or Contract recorded . �("� �County ecorder's Office, Record Yo. _� Page ���
� Name and address of mongagee �� \ t \ �%�+�� T'�
WDo you know if there is any assignee or bona fide owner or holder of the mortgage or rnnGact? Yes No If yes,
Qwhat is the name and residence? � �
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� z Does the owner of the above described real property own real property in any other County in the State of Indiana?
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(j Yes No If yes, what Coun[y and Taxing District?
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� Has this deduction been requested on that property for the cunent year? Yes
�
(J] Amount Allowed
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F
z COUNTY BOARD OF RE EW
,.,, ACTIONr�^..�
� APPROVED IN���Hi7_ ... _ �� ��
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SECREI'ARS OF BOARD
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b-.v a_ b-1'See False Statement Penalty Below � �"� Oj%%�
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��� IPERSO\ AUTHOftIZED BY DULS' E%ECVfED PoWER OF ATIOR.\EY) p
� J� �FULL RFSIDE\CE AUDRFSS OF OWNER — MUSf BE CIVEN�
,� � S 98
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IADDRESS OF AVI'HORIZED PEFLSO\I
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