HomeMy WebLinkAboutMortgage_Seibert (5)I_�
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Form a Fe•ised 19i1 ' ` FSling Fee SIDO
Pres�nb d by �Ae Sut. BooN of Tux Comnissionea O� 4^ O O U��_ O O
CERTIFICATE OF MORTGAGE OR CONTRACT INOEBTEDNESS _
TO BE FILED IN PERSON OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER.R'ITH THE COUNTY AUDITOR
QN WHICH THE PROPERTY IS LOCATED) BETWEEN MARCH 1 AND MAY 10, INCLUSIVE '
� (6-1.1-12-1 THROUGH 6-1.1-12•8) `�-
°'QUALIFICATIONS ON BACK•^ �
ATE OF INDIANA
I, (We)
COUNTY, ss: ' n�71
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ceRify that I, (R'e) was/were lega] resident(s) of [he S[atz of Indiana and owner(s) of real property on D1azch 1, 19 � and that this
statement is made Cor the purpose of obtaining a deduction from that real property located_n Taxing District (City, Town, Township)
L,egal Description/or Key Number �7 " '�W /y I O��-) � • 55 R L V
Described to wik
� Name on property ta�c records if different from above?
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A
z Are you the soie legal or equitable owner of the real estate? Yes No
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� If no, what is your exact share of interest in it? , ' �
� Assessed value ot real estate as of March 1, cunent vrar ,/���N' �Q�� �%/o.��
� . Amount of Mortgage or ContraM Indebtedness unpaid as of March 1, current year S�' ��� '�
U�.��, DSortRage or Contrect recorded County Recorder's Office, Record No. � Page � ��
.` Name and address of mortgagee or contract seller 'l`�'Qi.+Y�.O.IN �QJi7- �Q,� '
� Do you know if there is any assignee or bona fide owner or holder o( the mortgage or contract? 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 Count in the State f I�diana?
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(� Yes No If yes, w�hat Count and Taxin District. � ,� �,�
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d Has this deduction been requested on that�propei
fJ�� Amoun[ Allowed " �A ,
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H
z COUNTY BOARD OF REVIEW
,..; ACTION
(.Wy APPROVED IN AMOUNT OF S
3 REMARKS ���� V I ��b� .
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SECftETARY OF BOAR�
for the current year? Yes ^ No F� g 2 a 193�
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D / ' Uir�::.c� �' Yr' a-s ,(/
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'See False Statement Penalty Below
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UDDRFSS OF AVI'NORIZED PER50\�
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