HomeMy WebLinkAboutMortgage_LanfordForm5lte.ised 19•,1 Q�� D� F51iaR Fce SISM',,
Fhescribed by Ne Sum eonrd �! Tex Commissioners
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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 COUNTY AUDITOR
(IN WHICH THE PROPERTY IS LOCATED) BETWEEN MARCH 1 AND MAY 10, INCLUSIVE �
1 (6-t.1-12-1 THROUGH 6-1.1-12-8) �
� � '^QUALTFICATIO\S ON BACK•^ ✓
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/ STAT,� OF INL�iANA -��� COUNTY, ss: �
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certify that [, (We) was/were legal resident(s) of the�State of Indiana and owner(s) of real property on March 1, 19 f1_P— and that this
statement is made for the purpose of obtaining a deduction from that real property located in Taxing Dlstrict (City, Town, Township)
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Legal Description/or Key Number
Name on property tax records if different from above?
Are you the sole legal or equitable owner of the real estate? Yes
If no, what is your exact share of interest in i[?
Assessed value ot real estate as of March 1, curre
Described to wit:
/70�/y/
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P+1AR p � 1986
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Amount of Mortgage or Contract Indeb[edness unpaid as of March 1, �current year S � � 0 �—
�7ortgage or Contract recorded �� County Rewrder's Office, Record No. � page 3 6.� 2-
Name and address o( mortgagee or contract seller
Do you know it there is any assignee or bona fide owner or holder of the mortgage or rnntract? Yes
what is the name and residence?
No If yes,
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Does [he owner of the above described real orooertv� own real property in any other County in the State of Indiana?
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� Yes na
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If yes, what County and Tasing District?
Q Has this deduction been requested on that property for [he current year? Yes No
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(/j Amount Allowed
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z COUNTY BOARD OF REVIEW
� ACTION
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�.Wy APPROVED IN AMOUYT OF 3�
�-� REMARK£ � '
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. SECREfAftY OF BOAftO
DATE
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'See False Statement�alty Below
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�PERSO\ AUTNORIZED BY DUL' %ECVI'ED POWER OF TIOIL�EY)
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INLL RESIDESCE ADDRESS OF OWYER — MUST E GIVEN)
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IADDAESS OF Alfl'HORIZE EASO�)
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