HomeMy WebLinkAboutMortgage_BathonFarm 5 Revisd 19�1 ��`� � V � F51in6 Fre SI.Op
Preurib d by the Siare BmN af Tex Cammiuionen
CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS
TO BE FILED IN PERSON OR 8Y MAIL IK DUPLICATE EACH YEAR BY THE OWNER WITH THE COUNTY AUDITOR
"(IN WHICH THE PROPERTY [S LOCATED) BETR'EEN MARCH 1 AND MAY 1Q INCLUSIVE
� (6-1.1-12-1 THROUGH 6-1.1-12-8)
� �� '^QUALIFICATIOIM1S ON BACK^•
3.3
STATE OF INDIANA ;�� COUNTY, ss: O D O
��_ (We) / / l Q.u/-t.cct� r . 2� �!/1�A._ �. /d91.."�.k..r�t � �
�FUIL RAME� Q
" certify that I, (We) was/were legal resident(s) of the State of Indiana and owneKs) of real property on March 1, 19 `� and that this
statement is made for the purpose of obtaining a deduction from that real property lceated in Taxing District (City, Town, Tawnship)
Legal Description/or Key Number
.�9
Described W wit
� Name on property tas records if different from above? —
z o2-739
A
,Z Are you the sole legal or equitable owner of the real estate? Yes No
H
�
If no, what is your exact share ot interest in it?
� ��� 0
0= O OD
� Assessed value ot real estace as of March 1, current year �� ����� ���
� Amount of Mortgage or ContraM Indebtedness unpaid as of March 1, current year 3 05 �� � 7�.
��'�lortgage or Contract recorded tpJt�i� County Recordei s Office, Record Na '� �! Page �Qo �
I �_� A� �y, r' �
� Name and address of mortgagee or contract seller �� v/�'�-� ' o�-�-�//�-
� Do you know if there is any assignee or bona fide owner or holder of the mortgage or mntract? Yes � No If yes,
-�+•what is the name and residence?
� ��
. z Does the owner of the above described real property own real property in any other County in the State of Indiana?
� �s D 6 ,�
�j Yes No If yes, what County and Taxing DistricQ '
� Y
Q Has this deduction been requested on that property Cor the current ear? Yes No
Ui Amount Allowed � �� � �'+��! �/
� �,/
F ���,al.o �%
COUNTY BOARD OF RE IEW �•See False Statement Penalty Below
z ��� �� � ° P //J
� b�� p�
F ��y• 1' a L1/in .. ti ir/�
� O A N 3 �tib^- 6 1 �D �� lC- wners�euu.nnme�
� REMA��Y �.� ,�� ; d
IPENSO\ AU'fHOAiZED BY ULY E%ECITfED PoWEft OF ATTDIL\EY)
o�. �" ,1��' �d. 750 ,� 7,L�.c�� ��C .
,, " I,, IFULL RFSIDESCE AUURFSS OF OW::ER — MUST 8E GI�'6�1
O ;.yiniTOR � ��I�
�
��. � � �� �.�
\ SECRETARS' OF BOARD � � fADDRESS OF AUTHORIZEO PE .�i
L J .� � —' - " '",�