HomeMy WebLinkAboutMortgage_Moorei- _ , _ _
Farm o He�isN 19+�1
. • Prescribed bv Jie Suu� BosFd of Tnx Commissianers
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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
(IN WHICH THE PROPERTY IS LOCATED) BETWEEN MARCH 1 AND MAY 10, INCLUSIVE
(Crl.l-12-1 THROUGH 6-1.1-12-8) � � � (�
� • "•QUALIFI TIO\S ON BACK"• � �
3-�2-�'S ,�
STATE OF INDIANA COUNTY ss: ��J/'
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I, (Ne)
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certify that I, (R`e was/were legal resident(s) of [he Sta of Indiana and owner(s) of real property on March 1, 19 � and that this
statement is made (or the purpose of obtaining a deduMion from that real property located in Taxing District (City, Town, Township)
� �����.i�.(,I�1.� Described to wiC
I.egal Descrip[ion/or Key Number �� � �/--�- �",� p� � �� � � �`� �"'!�
A'ame on property tarz records if different from above? � q— 3 r c� 7
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.%, Are you the sole legal or equitable owner of the real estate? Yes No ° �
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� IC no, what is your exact share of interest in it?
� Assessed value of real estate as of March 1, current year ��— �J � �
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� . Amount of Mortga�r (�yo rac�d te � ess unpaid as oC Dlarch 1, current year $ ��/ ��
, t'� �— ^��o
�y MoRgage or Contract recorded ' County Recordei s Office, Record No. � Page j�.
�.�, ���iv � � 1y90 S � �"
,�Name and address of morigagee or contract selter
W Do you know if the��7yt��ona fide owner or holder of the mortgage or mntract? Yes No If yes,
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Qwhat is ihe name and residence? � �/ �
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zDoes the owner of the above described real property own real property in any othek County in the State, of Indiana?
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� Yes No If yes, wha[ County and Taxing District?
Qi Has this deduction been requested on that propedy for the curten �ar? Yes �� No �,_7 "" �� �
(/) Amount Allowed ' � �
Fh �� �,�, b 2ooy.,p w Pj a'�
z COUNTY BOARD OF REVIEW d�� •See Fatse Statement Penalty Below �
�,,; ACTION �Q Q� . oZOD,f -
'rWi - APPROVED IN AMOUNT OF $ l0 Ob �'" _ ���� �� �
3 p�J� lOW6Eft'S PULL NpNE�
� REMARKS � `� �� �pER506 AG'IHORIZED BY DULY EXECVfEO PoWER OF ATTDRFEY�
o �tio� a�c �D�
� (FULL RFSIDENCE ADORGSS OF OR'NER — MUST BE G1VEY)
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SECREfARI' OF BOARD /AODRFSS OF AUTNORIZED PER50�1 ��p
DATE �� �/%S. �9 c/' �� � J .
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