HomeMy WebLinkAboutMortgage_Stoll (3)FarmaRe.ised 14i1 . �(� � F�Iine Fes f1.00
Prescnb d by Ne Suie Boerd of Ta. Commiuio�ers � `\ •
v ���
CERTIFICATE OF MORTGAGE OR CONTRACT INDEBTEDNESS
. TO BE F[LED 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
" (61.1-12-1 THROUGH 8-1.1-12-8)
. ' �.''� - . •••QUALIF ATIO;S ON BACK•••, - / 1 �OQ
V
TE OF
1, (�ve)
certity thaf I, (1Ve) was/wer��al resident(s) of�.t
statement is made for the p se of obtaini�g a
L.egal Description/or Key Number
� IQame on property tax records if different from above?
z
..
A
,Z Are you the sole.legal or equitable owner of the real estate? Yes
H
� If no, what is your exact share o( interest in it?
ss:
of Indiana and owner(s) of real property an Dlarch 1, 19 — and thet this
�n from that real property located in Taxing Distrid (City, Town, Township)
l
�
Described to wit:
" � �O .. �e
g � � �I �%
� ' ��
OAssessed value of real estate as of March 1, current year
� . Amount of Mortgage or ContraM Indebtedness. unpaid as of Dlarch 1, cunent year. $ � "� O -
, � l�
�� D7ortgage or Contract recorded _ County Recorder's Office, Record No. � Page �
�� Name and address of mortgagee or contract seller
WDo you know if there is any assignee or bona fide owner or holder of the martgage or rnntract? Yes No It yes,
Qwhat is the name and residence?
a
m
zDoes the owner of the above desc���� ow real property in any other County in the State of Indiana?
H
(} Yes --, A`o If yes, what Caunty and Taxing District?
� �EB 15 1990
Q Has this deduction been requested on tha property for the cunent year? Yes
(fj Amount Allowed ' //��/��
� AUI
E �"1-0o G/,d/Q�i �
z COUNTY BOARD OF REVIEW
�„i ACTION
(.Wy APPROVED [N AMOUNT OF $ _
�
3 REMARKS � � �
O
A
' SECRETARI'OF BOARD
DATE
�bba
No
0
�� � �i
z a ��
- 'See False Statement Penalty Below �
�,,?i �nj - aav$- p
�� �' �" �°
ION'NER'S FUIL NAME� �O
�-P
� �PERSON AUTHORIZED BY DULY F.%ECUTED PoWEft OF ATTDRIEY)
�? ^ �.� � 0 �• S'To uT sT.
(FULL RESIDENCE ADDRESS OF OH'\ER — MUST BE GIVEY)
�1��
)_� _�lNCFioN, Z,�. `f ?c��
, (ADDRE55 OF AVI'HOR[ZED PERSO\)
�� 2 _ g� , ��