HomeMy WebLinkAboutMortgage_ChristmasFarm 5 ReviaM 1%1
Prcxribd by N<State Bmfd of Taz Commissionm
Filing Fee SI.00
C�
CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS
TO BE FILED IN PERSON OR 8Y MAIL IN DUPLICATE EACH YEAR BY THE OWNER WITH THE COUNTY AUDITOR
� '(IN WHICH THE PROPERTY IS LOCATED) BETWEEN MARCH 1 AND MAY 10, NCLUSIVE
i
M � /,.
�`„ (61.142-1 THROUGH 6-1.1-12-8) I �� ^
N i O� i'� O � O •••QUALIFICATIONS ON BACK•O ijy �� �
\ (!
/
�ATE OF INDIANA a COUNTY, ss: /�
l.r.����
I (we) � . . v v .-� ��— �-.�..—.�
(PUIL NAME) o
�certify that [, (We as/were legal resident(s) of the State of Indiena owner(s) of real property on March 1, 19 Q�and that this
statement is made �for the purpose of obtaining a deductian from th real property �ted in Taxing District (City, Town, Township)
Described to wiL
Legal Description/or Key Number
� Name on property ta�c records if different from above?
z �
�
ca
,Z Are you the sole legal or equitable owner of the real estate? Yes No
rr
� If no, what is your exact share of interest in it?
� Assessed value of real estate as of March 1, current year ��� ��� O
� Amount of Mortgage or Contract Indebted e s unpaid as of March 1, current year S /� �• [L ��
�y��lortgage or Contract recorded County Recorder's Office, Record No. � Page �
� Name and adiress �f m�rt6agee or contract seller �� •
�� Do you know if there is any assignee or bona fide owner or holder of the mortgage or contract? Yes No - If yes,
j� what is the name and residence? ,
a'�
� �
zDoes the owner of the above described real pmperty own real property in any other County in the State of Indiana?
� �60f-� i (��v
� Yes �, No If yes, what County and Taxing District? �
Q Has lhis deduc[ion been requested on tha[ propedy (or the current year? Yes No
'�" — 0�-
� (/� Amount Allowed
F ��? a! � ab�� Pve��
,z COUNTY BOARD OF � VIEW �_ S'�'�I•See False Statement Penalty Below
�„� ACTION �
W '
Ey APPROV U` F� — �ow� �s eu . w��er
" � ��`-���-��� �
3 REMAR � ���
� �PE R AUTNORIZE 9S DUL E%ECVfED POR'ER OF A RhEi}
�F' n0 a
�� ,� � r �� (FULL RESIOERCE ADURE55 OF OWRER — MUST BE GItlEN�
z o$ p�
A• �L �,—,-.�����a- O� � �
�';�,qLtx TA " OF D P IADDRFSS OF AVfNORIZED PERSO\) �
'. nATF. _ _ ' ae ' � .
`/� %'
��