HomeMy WebLinkAboutMortgage_Weber (6)�� Form � He.ised IAA1 _ l �
PreacnbM by Ne _uie Baerd o(Tex Commiss�oners
Filing Fee�S1A0
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
(IN WHICH THE PROPERTY IS LOCATED) BETR'EEN MARCH 1 AND MAY 10, INCLUSIVE
�� (61.1-12-1 THROUGH 6-I.Id2-8)
^•QUALIFICATIONS ON BACK°' `
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STATE OF INDIANA COUNTY, ss:
I. (\Ve) � "Id�l/M i ' ':� �O..C�.X�- ��s/�+.v"— �,(�,�.�/
� - IFULL SAMEI
certify tha[ I, (R'e) was/were legal resident(s) of the State of Indiana and owner(s) ot real property on nlarch 1, 19 ��and that this
_ statement is made for the purpose of obtaining a deduction &om that �eal� property located in Taxing District (City, Town, Township)
Legal Description/or Key Number
�� Name on property tax records if different from above?
z
..
A
,Z, Are you the sole legal or equilable owner of the rea] estate? Yes No
H
� If no, what is your exact share of intezest in it?
Q�i _ .
Described to wit:
55 �: s
�9- a � ��
� Assessed value of real estate as of b4arch 1, cunent year "tOO � I d�b ��
� Amount of Mortgage or Contract Indebtedness unpaid as of March 1, current yeaz'$ � ���� �
, Afort�age or Contract recorded County Recordei s Office, Rewrd No. � Page s � a�
-G :Name and address of mortgagee or contract�seller �C �^�'�
4�.
WDo you know it there is any assignee or bona fide owner or holder of the mortgage or rnntract? Yes No If yes,
Qwhat is the name and residence? - .
a -� ,� ,�/?
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z Does the owner of the above described real property own real property in any other Count � in the State ofy� Indiana?
~ E�� Yes No- If yes, what County and Tasing District?
�
d Has this deduction been requested on that property for the current year? Yes No
�
Cf1 Amount Allowed .
N
x -oo
F
z COUNTY BOAR OF REVIEW
,,.� ACTION
[.Wy APPROVED 1N AMOUNT OF S ,
IH
� REMARKS
N i ��A I
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A
SECftETARI' OF BOAR� .
MAY 0 8 1989
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� fl /�Y o �- �° - . AUDI?OR. .
I_� /�'See False Statement Penalty Below h/_� (� rJ p�
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3 � �.�-�.-P-�. �-��-�-�- �.-p—
(OM[ER'S FUIL NAME� CJ /
' O� IPERSOS AUTHORIZED BY DULY EXECUTEO PoWER OF ATIORNEY)
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// �FULL RFSIDE\CE `eCD�i RGSS OF OtY\EA —.11UST BE Git'E.l'�
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(ADURFSS OF AI7IHORIZED PERSO\�
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