HomeMy WebLinkAboutMortgage_Kendle�
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Form.i Reaisd 19�1 w� �nR Fee 51.00
Presm6ed by Ne au`e Bmed af Tex Commis�ianers O/^.' �� / i�� — ^
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CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS �
TO BE FILED IN PERSO\ OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER K'iTH THE COUNTY AUDITOR
- pN R'HICN THE PROPERTY IS LOCATED) BETR'EEh MARCH 1 AND MAY 10, INCLUSIVE
(6-1.1-12-1 THROUGH 6-1142-8)
'°QUALIFICATIO\S O�' BACK^•
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STATE OF INDIANA �C��r!„� COUNTY, ss:
I, (R'e)
certify that I, (�Ve) was/were legal resident(s) of the S[ate of�ndiana and owner(s) of real property on March 1, 19 �and that this
sta[ement is made for [he purpose of obtaining a deduction from that real property loca[ed in Taxing District (City, Towq Township)
Described to wit:
Legal Description/or Key \umber
Name on property tax records if different fmm above?
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Are you the sole legal or equitable owner of the real estate? Yes
IC no, what is your exact share of interest in it?
No
Assessed value of real es[ace as of March I, current year �[ U�' �f e2-� O
Amount of b7ortgage or Con[ract Indebtedness unpaid as oC March I, current Year S 9 �� O
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Mortgage or Contrac[ recorded �l�f/� County Recorder's Office, Record A'o.
Name and address of mortgagee or contract seller
Do you know if there is any assignee or bona fide owner or holder of the mortgage or mntract? S'es
what is the name and residence?
D6S-
� Page 3 �
_� No If yes,
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Does the ow�n^A ^� th� ���� described�, real property own real- property in any other County in the State of Indiana?
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Yes � No 7- If s, what County and Taxing District?
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Has this deductioA��T(� e o that property for the wrzent year? Yes � No
Amount Allowed �
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COUNTY BOARD OF
ACTI ON
APPROVED IN AMOUNT OF 3
REMARKS D�,q
DATE
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'See False Stacement Penalty Below
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SECftETARI' OF BOARO ��
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