HomeMy WebLinkAboutMortgage_Fitch (3)/Re.ised 195� . � ' .
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\/ CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS
TO BE FILED IN PF.RSON OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER WITH TFiE CO
� (IN R'HICH THE PROPERTY IS LOCATED) BETWEEh MARCH 1 AND MAY 10, INCLUSI'
� �f �� � /'�� (61.1-12-1 THROUGH 6-1.1-12-8)
� � O` l/ l/
°•QUALIFICATIONS ON BACK'•'
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Filing Fre SL00
AUDITOR
�
D STATE OF INDIANA `�� CO NTY, ss: �
I� (We) '�X/� � 1�-� �[.Y�i>� ✓ �U�I. �%� -
�FULL \ 1
certify that I, (We) was/were legal residen[(s) of the State of Indiana nd owner(s) of real property on �iarch 1, 19 �� and that this
statement is made for the purpAse of obtaining a deductibn from tha[ real property located in Taxing District (City, Town, Township)
Legal Description/or Key Number %" •
�ic
Described to wit
� Name on property tax records if different from above? �
z
�
Z, Are you the sole legal or equitable owner o( the real estate? Yes No QO� �� � �
�
� If no, what is your exact share of interest in it?
�� Assessed value of real estate as of March 1, current year
A. Amoun[ of Mortgage or ContraM Indebtedness unpaid as of March 1, current year 3 � O D� !
� plortgaFe or Contrac[ recorded '`^'w� �� County Rewrder's Office, Record No. � Page e�,��
� Name and address of mortgagee or contract seller ��'°"°�"^�^ —""" ��
W
WDo you know ifi�g y assignee or bona fide owner or holder of the mortgage or rnntract? Yes A`o If yes,
/,�a �� �1
Q what is the nati a�e �
� � �
I Does the o��yper of the above described real property own real property in any other County in the State of Indiana?
t} Yes �`No`��R(�(�es hatSCounty and Taxing District?
a .
Qi Has this deduction been requested on that property for the current year? Yes No
(/� Amount Allawed ' " �% � ` �o�b � �0 ` 62
x Q�' o � a b�' r• � ��
zCOUNTY BOARD O� REVIEW ��(? J��See False Statement Penalty Below �
,..; ACTION
[.Wy APPROVED IN AMOUNT OF S 6` � � ��� ' �
� , ION'SER'S FU�I. SAMEI
1 REMARKS ���'3 a�� '� $ �
. ��� Q W �� 'fl / O �AUTN�I1 {yl DULY E%ECUTED �i'E� ATIDR.\EYI
�V I ? /
)f/l� �
� (FULL RESIDERCE ADDRGSS OF OWRER — NUST BE GIVE\�
z'
A � 9
SECREfdRY OF BOARD � (AD�RFSS OF AVI'HORI2ED PEECSO\I