HomeMy WebLinkAboutMortgage_StonePFESCPIBEO BY STATE BOARU�OF T�% COMM�SSIONEX9 �
AFFIDAVIT OF MORTGAGE INDEBYEDNESS
being duly su�orn, upon oath certify that I, (�ITe) waslwere legal resident(s) of the State of Indiana and owner(s) of real
property on March 1, 19�2_ on Rhich a bona fide mortgage existed, and that this statement is made for the purpose of
obtaining a mortgage deduction from that real property located in Taxing District (City, Town, Township)
Described to �cit:
Legal Deseriptio�/or %ey Number LOt #97� d pt. Of S� Of NEa Of S19�T35�R10W. A
Lot #96 - a pt of S� of NE; of S19, T3S, R10W. Also, Lot
a' nt r�P C�r nf NF�. �f Cl0 T]C Dlllm
Name on property tyx records if different from above?
Are you the sole owner of the real estate? Yes , No—X—,
If no, what is your exact share of interest in it?
Assessed value of real estate as of ilfarch 1, cunf
Amount of �Iortgage Indebtedness unpaid as of March 1, Current year $ �; y� 4 fi 6_ 69
ilfortgage recorded G1bSOI1 County Recorder's Office, Record No. � Page 1 �SQ
,�'ame ana address of mortgagee Farmers & MerchantSBank. Fort Branch, IN 4764R
Do you know if there is any assignee or bona fide owner or tyOlder of the mortgage? Yes , N3C X , If yes,
what is the name and residence? D✓ � �o
P 1 � ��1 �4��.fi�
Does the o�mer of the above described real property ovm real property in any other County in the State of Indiana?
Yes , NoX , if yes, what County and Taxing District? / D_ "i �/ 6X�f/�
Has an ag�or��rtg�� deduction been requested on that property? Yes No X, . Age
MortRage _. Amount allowed � ��
BOARD OF REVIER'
Approved in amount of
Remarks n
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Penalty Below
IOWNER'S FYLL NAME)
�PEqSON AIITXORI2ED BY DULY EYECUTEO POWEq OF ATTORNEY)
Indian Hills, Fort Branch, IN 47648
/�r% IFULL RESIOENCE ADORESS OF OWNER - MYST BE GIVEN)
ADORESS OF At1TXORIZEO PEq50N
Subscribed and sworn to before me, the undersigned
or
Teresa S. Perkins, Notary Publiqn a�a for said County,
this lst day of MaY `-�, 19$?
(Seal) Notary Public � � �� —