HomeMy WebLinkAboutMortgage_MeadowsForm i Ft�.i d IAl 9 ���`t ��O Q
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CERTIFICATE OF MORTGAGE O ONTRACT EBTEDNESS �
� 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) BE7'R'EEN MARCH 1 AND MAY 1 INCLUSNE
(6-l.l•12-1 THROUGH 6-1.1-12-8)
� � � ^'QUALIFICATIONS ON BACK•° � O�
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nSTATE OF INDIANA
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COUNTY, ss:
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certify that I, (We) was/were legal resident(s) of the State et � d'Ati:-anfl owner(s) of real propertY on DSarch 1, 19 u and that this
statement is made for the purpose of obtaining a deduction from that real property located in Taxing District (City, Town, Township)
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Legal Description/or Key Number
x' Described to wik
Name on property tax records if different from above?
Are you the sole legal or equitable owner of the real estate? Yes � No
If no, what is your exact shaze of interest in it?
Assessed value of real estate as of March 1, curtent year •�+ �� ��� �� - �/�O
Amount of A1ortgag ontract I btedness unpaid as of March 1, current year S �y�� �7�,��� ��
MortRaKeg�mtrTeti'scord�d �eLa(.�, _ �mi Recorder's Record No. � Page �0 �
Name and address of mortgagee or contract seller _�
Do you �cnow if there is- any assignee or bona fide
what is the name and residence?
the
'AR il 19O 8
Does the owner of the above described �ieal pFOpOerty oown real property
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Yes No If yes, whdVt�Go4�byC �t?
AUQlTOR .
Has this deduction been requested on that property for the cunent year? Yes
Amount Allowed
OARD OF $EVIEW
ACTION
No
7f yes,
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in any ather County in the State of [ndiana?
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�03
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/ ,.����''See False Statement Penalty Below
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APPROVED IN AMOUNT OF S�04�' � bQd
REMARKS � ���-� �y�
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SECftETARY OF BOARU
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IADDRESS OF AIII'HOP D PERSOti)
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