HomeMy WebLinkAboutMortgage_YoungsonJ% Form 5 Reviad 198i /' /l / // 3 3 [(/ Pline Fee SI.00
Pvcribed by Ne S�a�e Boerd of l'ez Cammusianm �/ V ^ �
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CERTIFICATE OF MORTGAGE OR�CONTRACT INDEBTEDNE55
TO BE F7LED IN PERSON OR BY MAIL IN DUPLICATE EACH YEAR BY THE OWNER WITH THE COUNTY AUDI
'(IN WHICH THE PROPERTY IS LOCATED) BETR'EEN MARCH 1 AND MAY 10, INCWSIVE
(61.1-12-1 THROUGH 8-1.1-12-8)
�1^ •^QUALIFICATIONS ON BACK••• DD�
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STATE OF INDIANA COUNTY, ss:
I. (we) w,c.c�c.r—e—»-v r N v� -
certify that [, (We) was/were legal residenUs) of the State of
statement is made for the purpose of obtaining a deduction
Legal Description/or Key Number
na �id �wneds) 6f real property on Mazch 1, 19 D_L and that this
that zeal propeyt9�lceated in Taxing District (City, Town, Township)
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Described to wit
� Name on property ta�c records if different from above?
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z Are you the sole legal or equitable owner of the zeal estate? Yes No
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� If no, what is your exact share ot interest in it?
� Assessed value of real estate as of Mareh 1, current year �� ���� �% Q
� Amount of r7artgage or Contract Indebted ess unpaid as of March 1, current year S ��%d �, a O
�p7ortgage or Contract recorded Co ty Recorder's Office, Record A`o. � Page ��.
� Name and address of mortgagee or contract seller
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� Do you �rl�w i�j th�e is a�n�a'�s�ign,ee or bona fide owner or holder of the mortgage or crontract? Yes � No If yes.
U � �.�9 .�� � S—'(Y�'u !
d what is the name and residence.
a MAR 1 � i981
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z Does`�f �; th ti bovePdescribed real property own real property in any other County in the Stace of Indiana?
/:��n�TOn�'�� � L
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(j Yes � No IC yes, what County and Taxing District? /�
Q Has this deduction been requested on that propeRy for the current year? Yes No // C�GW7/'�'�
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Cfj Amount Allowed � p� �C%E1Z ! L�/l
N� �-a�-o� �b�4'�
z'- COUNTY BOARD OF REVIEW •See False Statement Penalry Below
,,,, ACTION �
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(.Wy APPROVED IN AMOUNT OF $ �
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� REMARKS � � /_
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o �007
A SECRETARY OF BOARD ��
DATE 7 _ (a .� �y 0
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