HomeMy WebLinkAboutMortgage_Kissel (9)F m;��,� � ql q�, ���eea, �
Prescribed by �M1e �u�e Bm.d of Toa Commissianers
CERTIFICATE OF �A6E OR CONTRACT INDEBTE� ESS
TO BE F[LED IN PERSON OR BY MAIL IN DUPLICATE EACN YEAR BY THE ORNER WITH THE COUNTY AUDITOR
(IN WHICH THE PROPERTY IS LOCATED) BETWEEN MARCH 1 AND MAY 10, INCLUSIVE
(61.1-12-1 THROUGH 6-1.1-12-8)
`'�' "'QUALIFI ATIONS ON BACK•'•
�^�ATE OF�INDIAI�V J COUNTY, ss: 9�
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I; (We)
✓
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certify that I, ({Ve) was/were legal resident(s) of [he State of Indiana and owner(s) of real property on Dlarch 1, 19 � and that this
s[atement is made Cor the purpose of obtaining/a�eductionSrom that real pfppedy located in Taxing District (City, Towq.Township)
Legal Description/or Key Number
� Name on property tax records if different from above?
z
,Z, Are you the sole legal or equitable owner of the real estate? Yes v wIv�
�
�
� if no, what is. your exact share of interest in it?
� Assessed value ot real estate as of Mareh 1, curzent year . __ _
� . Amount of Mortgage or Contract Indebtedness unpaid as ot Dtarch 1, current year S� J ���//////��'j//
,� Dlortga�e or Contract recorded County Recorder's Office, Record No. � Page _�z—�-6
� I�'ame and address of mortgagee or contract seller
WDo you kno�r if there is any assignee or bona ftde owner or holder of the mortgage o ntract? es - No If yes, �
Qwhat is the name and residence? —
a
�
z Does the owner of the above described real pmperty own real property in any other County in the State of Indiana?
H
tj Yes No If yes, what County and Taxing District?
M
Has this deduction been requested on that property for the
' Described to wik
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Amount Allowed
COUNTY BOARD OF
ACTION
APPRO\'ED IN AMOUNT OF S
REMARKS
year? Yes No
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� �,UDITOR
'See False S[atement Penalty Bel
_ 63 i,�-��� A D
^ � ION'� ,R `F4 NAME�
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IPERSO\-AUTNORIZEU BY DULI' E%ECUTEp PoWER OF ATTDR9EY)
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(NLL RFaiDESCE ADDRFSS OF OW\ER — MUSf BE CIVES�
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9�(ADDRFSS OF AVfHORIZED PER50\�
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DATE II 6—o2c3�/8 �/��
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