HomeMy WebLinkAboutMortgage_Reeves (4)Form u Reviaed 195t
PrecQibavl by Ne State Boeed o( Tex Commiasianen
Filing Fee EI.00
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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 K'ITH THE COUNTY AUDITOR
�(IN WHICH THE PROPERTY IS LOCATED) BETWEEN MARCH 1 AND MAY 1Q INCLUS[VE
� (6-1.1-12-1 THROUGH 6-1.1-12-8)
"'QUALIFICATIONS ON BACK••' /O! Q
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STATE OF INDIANA .��Lu'-Q�rr�� COUNTY, ss: �/�
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�FUIL NAME�
certify that (We) was/were lega] resideni(s) of the State of Indiana and owner(s) of real property on March 1, 19 �and that this
statement is made for the purpose of obtaining a deduction from that real prQperty located in Taxing District (City, Town, Township)
Legal Description/ar Key Number
� Name on property tax records if different from abave?
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,� 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 of interest in it?
OAssessed value of rea] estate as of March 1, current year
A Amount of Mortgage or Contract Indebted ess unpaid as of March 1, cunent year S
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r //�Described to wit:
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��\lortgage or Contract recorded County Recorde 's Otfice, Record i._—�� Page �3� �
W Name and address of mortgagee or contract seller
� Do you know if there is any assignee or bona fide owner oz holder of the mortgage or contract? Yes No I! yes,
Q�what is the name and residence? l�—� � ��
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z Does the owner of the above described real property own real property in any other County in the State of Indiana?
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�j Yes No If yes, what County and Taacing District?
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Q Has this deduction been requested on that property for the current year? Yes —� No n� �
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C/2 Amount Allowed
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z COUNTY BOARD OF R� VIEW
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SECRETARY OF BOARD
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IPEASO\ AUTIORj�ED BY D�. E%ECUTED POWER OF A \'
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/AODRFSS OF AfTI'HORIZED PEItSOY)
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