HomeMy WebLinkAboutMortgage_Antey�
Form.i Re�isid IA51 "
_ Co
F51ine Fre SI.W ��
Presrnbed by tL. �iatr BoaN af Tux mmusianers �
CERTIFICATE OF MORTGAG �OR CidNT ACTgI DEBTEDNESS -��
TO BE FILED IN �PERSON OR BY MAIL Ih. DUPLICATE EACH YEAR BY THE OWNER WITH THE COUNTY AUDITOR
.(IN WHICH THE PROPERTY IS LOCATED) BETR'EEN MARCH 1 AND MAY 10, INCLUSIVE .
� (6-1.1-12-I THROIiGN 6-1.1-12-8) ,
���� "'QUALIFICATIONS ON BACK^• , /
� .. 4i . A ✓ _
I, (We)
certify tha[ I, (We) was/were legal
statement is made for the purpose
Legal Description/or Key Number
COUNTY, ss:
/
of the State of Indiana and owneds) of rea property on arch 1, 19 and that this
ig a deduction from that real pzoperty tocated in Taxing District (City, Town, Township)
� A'ame on property tax records if different from above? �.
z
a --
,.7.. Are you the sole ]egal or equitable owner of the real estate? Yes No
►-i
�
� If no, what is your exact share of incerest in it?
� Assessed value of real estate as of Dlarch 1, current year 3 3'
Described to wit
���
� Amount of Mortgage or Contract d bt ness unpaid as o( March 1, cursent� year $ /�-� �D `-'
� '� �Z
niortgage or Contract recorded nty rdei s ffice Record No. � Page �
t � �. •
�
dame and address of mortgagee or contract seller
�. .
WDo you know if there is any assignee or bona fide owner or holder of the mortgage or rnntract? �Yes
� Q what is the name and residence?
Q�
�
�' "
No It yes,
z Does the owner of the above described real property own real property in any other County in the State of Indiana?
►-i jJ �pp�
�j Yes -� No If yes, what County and Tarzing District? �a �.N, �� �+ �+
� -- :u a
Q. Has this deduc[ion been requested on that property for the current year? Yes
�
(Jl Amouut Allowed
►-i
x
�
z COUNTY BOARD OF REVIEW
,,,., ACTION
[.Wy APPROVED IN AMOUNT OF 3
IH
3 REb3ARKS
� .. � A��
{,�_
Fy
SECRETAftY OF BOARU
' "° �&� 1989
a��°C� `�� ��``� °P�� s�tiu°�`�`iT'
�� a J' O�See False Statement Pen�ty Below
��D
� \ �El�" `� F` '�—`��__"'.d-`° ��
�OWNE 'S FU OANE�
�p�a ti5
�`� � IPERSOShUTFI�� DULY E% ��'� QR OF A�yJ �
A H/ / /
� V !'� Z Gi�l7
(FULL RFS�IDE\GE ADDRFSS OF ON\ER � BE GIVE\�
V �
(ADDRFSS OF AVI'HORIZED PER50\�
�'l4[00 (ol9d f441OcpTt�. !�,
�.. � _ y'�' 'fJ�
�
'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_. ; FOR DEDUCTION FROM ASSESSED VALUATION
� � . State Form 43709 (R77 / 6-09)
��" Presoihed by Departmenl af Local Govemnrent Frence
NSTRUCTIONS:
To be filed in person or by mail wiN the CountyAuditor or Counry Recorder of the counry where (he pmperty is located.
Fiiirg Dates: 1J Real Property: Must file during the year fo� which Ihe deducUon is sought. D E
2) Mobi/e / Manufectured Homes rrot assessed as Real Property Must file dunng the fweNe (72) months
6etae March 31 of each year Ihe deducfion is sought.
C.
See reverse side /or additional instrucfions arM qualifications.
>��a' �nlnwinrn..nn�ralln. .n<r.;fr:...e.,...e..e...e..ne�
� Z�ntyAUditor
n_ CounN Remrder
- GIBSON cUUrv � , •,�••� ".•.
Ta�dpg �is�triri Key number / legal desmiption Ref �d numDer Pa e numbu
7 7, -/ - O l-�t a d� - O '/ 3- D O/iZ SoL/
As¢s� vaqc d real paperty es d Martqa ge / Cantracc irdehted�ress unpaid as W Mortqage I Contaz3 irdehtedness �mpaid as d Is ihe eppBtanl ihe sde
Ma�h 1. nvmnt Y� Mamh 7, airte�rt year dete of aPP��� I�al n equitaGe ameR
9� ❑ Yes ❑ No
If ro, wfiat Cs his I her erart share ot interest? If wmed wiM someone oNer Ihan spouse. udkate wflh whom
If �urtie m �emtl is dMUent than Nat of aPPlicanL 4Mitate EeWvr. �61Mi�°perty m Question: Mnua�y Ass¢ssed
^�}x�ROPeRY Q?mn!aMAss�sed _ . _
Name of mortgagee or mntrar� seller
Address ot rtartgagee w contracl srAer (number n�
Name W assignee w other owner or hdder of nqr�gaga
�
DeducCan approved in tlre amouni ot
20 I 20 I 20
�
I I We certify under the penalty of
owner I wntracl buyer of the afon
the
whatmunt�7 � tTap� Dc
COUN7Y AUDROR
20 2�
�ir
1\D...Y �/�.....
.........
Dra�ver �
' .......
NO. . � � ...
Card ... . ....
5�, 9���
t 20 20
nd toregoing infortnation is we and cortea antl Nat the applicant is a resident of Indiana arM
date appliratlon is filed.
Euly ezewteC Power oflCtl6may or by IC G7.1-12-0.7 I Date (rtronN. tlay, yea�
V
I person (numberand sbee; dry, slate, ard LPmde) ,
r,