HomeMy WebLinkAboutMortgage_Lankford (2)Form i Re�iYd IA_I � � F�R Fee SL00/,
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CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS "
TO BE FILED IN PERSOti OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER R'ITH THE COUNTY AUDITOR
(IN WHICH THE PROPERTY' IS IACATED) BETWEEN MARCH 1 AND MAY 10, INCLUSIVE
' (6-1.1-12-1 THROUGH 6-1.1-12-6) • �
� '°QUALIFICATIONS ON BACK•° /��
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STATE OF INDIANA �a�.(�a-�+� COUNTY, as:
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certify that I, (R'e) was/were legal resident(s) of the State of Indiana and owneds) of real property on Mamh 1, 19 a O and that this
statement is made for the�purpose of obtaining a deduction Gom that real property located in Taxing District (City, Town, Township)
Legal Description/or Key Number
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Described W wit:
� �?Qame on property tarz records if different from above?
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z Are you the sole legal or equitable owner of the real estate? Yes No
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� If no, what is your exact share oC interest in it?
� Assessed value of real estate as of �March 1, current year �?�90 -/57�{a -/8'd3m
� . Amount of Mortgage or Contract Indebtedness unpaid as of March 1, current year S !� 0 O 0��
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Mortgage or Contract recorded /�-�+�7✓ County Recorder's Office, Record No. � Page ��
wl'" � � . �G �.�„�.�.,.. �.��-�.
�� Name and address of mortgagee or contract seller �1/A'
WDo 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? _ �
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z- Does the owmer of the above described reat� property own real property in an��dlAeeJ �o�w�ychn the State of Indiana?
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�j 1'es No If yes, what County and Taxing District? _
Q', AUOITOR
Q Has this deduction been requested on that property for the wrrent year? Yes No
C/j Amount Allou•ed ' � �A.�—��� � � � / • u �
E �l�i at a 30 � ff��' `. a 1 // ��
z COUNTY BOARD OF R IEW �p ��' 'See False Statement Penalty Below
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Ey APPROVED IN AMOUNT OF S 0 • ��
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SECRETARS OF F10ARD � UDURESS OF AVI'HO ED PERSOY� �
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