HomeMy WebLinkAboutMortgage_Bryant (3)Farm.i Re�ised lAil
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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 COUN'1'Y AUDITOR
pN WHICH THE PROPERTY IS LOCATED) BETR'EEN MARCH 1 AND MAY 10, INCLUSNE �/'�O
.(8-11-12-I THROUGH 6-1.L12-8) / ��
� �ba ��-{,� ^•QUALIFICATIONS ON BACK•O / �
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� STATE OF INDIANA ,,[�_ COUNTY, ss: �
I, (We)
.. _� �....._, �
certify that I, (We) was/were legal resident(s) of [he State o( Indiana and owner(s) of real property on March, l, 19 �and that this
statement is made for the purpose of obtaining a deduction Crom that real property located in Taxing District (City, Town, Township)
/ �� Described to wit:
Legal Description/or Key Number / / � '� � ~
� Name on property tax records if different from above? -
z. .
~ /� Q t
z Are you the sole legal. or equitable owner of the real esfate? Yes � No - y(�� � u� j
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!'
� If no, what is your exact share of interest in it?
OAssessed value ot real estate as oF March 1, cursent year (0 3 0-� 38'0
A . Amount of Mortgage or Contzact I(n�d�ebtedness unpaid as of March 1, cunent year S oZi�O �
`�" n7ortga�e or Contract recorded_�1-titT}sr!Y+�� County Rernrder's Office, Record No. s Page 35 9�
W • /�_
� Name and address oC mortgagee or contract seller g, ��(� (f�G�
' W Do you know if there is any assignee or bona fide owner or holder of the mortgage or contract? Yes � No If yes,
Qwhat is the name and residence? DO
Q+ � .
(/� `if'� "—
zDoes t�� owner of th ove described real property own real property in any other County in the State of Indiana?
� N�AR iG i�� �6�5-�
(} Yes No f yes, what County and Taxing District?
f�; `...1. � . Oo
Qi Has Lhis dedu����r este on that property for lhe cuaent year? Yes No `
C/� Amount Allowed ' n � � � �-�� �'^ � �
�t-� p
� � � � � � 0 � � � .
C UNTY BOARD F REVIER' S'b� •See False Statement Penalty Below
z ACTION � y � '
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APPROVED IN AMOUNT OF S
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D 1 O l o,v s� � �o' • [ 07 �+ y P- a,/i'
� 0 � IOWRERS FUil ANE�
7
D� "�PE2i0\ AUTFiORITED BY DULY EXECVI'ED POWER OF A1'IORFEY�
�_�� �/i0._.GL oS!- '
(FVLL RFSIDENCE AUDRFSS OF ON'NER — MUST BE GIVEA�
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