HomeMy WebLinkAboutMortgage_Wallis (2)r�' .
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Farm 3 Re.i..d �9fi1 � ///yyy� �Filine F« iL00
Preecribed by tLe S�s�e BoaN of Tax Commissionere /� ���
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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 R'HICH THE PROPERTY IS LOCATED) BE7'R'EEN MARCH 1 AND MAY 10, INCLUSNE
� (61.1-12-I THROUGH 6-1.1-12-8)
`°QUALIFICATIONS ON BACK°• ` QO�
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STATE OF INDIANA -�*' COUNTY, ss: �
I, .(We) � � ww�.c.�ui
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certify that I, (�Ve) was/were legal resident(s) of the State of Indiana and owner(s) of real property on March 1, 19 � l_ and that this
statement is made for the purpose of obtaining a deduction from that real property located� arzing Dis[rict (City, Town, Township)
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T�� Described to wik
Legal Description/or Key Number
� Name o� property taY records if different from above?
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A
,� 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 real estate as of March 1, current year J�� '°� O' �
� . Amount af Mortgage or Contract [ndebtedness unpaid as of March 1, current. year 8 �
� A1ortgaRe or Contract recorded
n=4e4,'Name and address of mortgagee or contract seller.
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9, � U�S
County Recorder's Office, Record No. � Page
W Do you know if there is any assignee or bona fide owner or hotder of the mortgage or rnntract? Yes �No If yes,
� what is the name and residence? �
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I� . - -� - - � i
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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� Yes No If yes, what County and Taxing District? � _
Q Has this deduction been requested on that property tor the wnent ye � es- �� No
� n �D%'� a0`�B-� A,t%
� (/� Amount Allowed _
F `� �i� � 8 . _
z COU Y BOARD OF REVIEW
,.., ACTION
[.Wy APPROVED IN AMOUNT OF S
I�1
3 REMARKS
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A
SECREI'ARl' OF BOARD
DATE
MAR 14 1989
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• AUDROR �
/�,� j. a/'See False Statement Penalty Below
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pIOW\'ER'S FULL \AME�
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IPERSO\ AUTHORIZEU BY DULS' EXECVI'ED POWER OF ATTOR.\EY)
��� .'E�CE AD�n'OF'�MUST BE GIVEN)
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' �AODRFSS OF AVfHORIZED PERSO\� . /
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