HomeMy WebLinkAboutMortgage_Robinson^'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
__._ . FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn d3709 (R17 / 609)
�' 1 Presoi6etl by Depanment oi Lo�l Govemrtrerit Frence
u�.
INSTRUCTIONS:
To be filed in person or by mail with the County Aud'ROr or Counry Recorder of the counry whe�e the pmperty is bcated.
Filirg Dafes: i) Real Pmperty: Must fi!e durirg fhe year lor which the deduction is sought.
2) Mo6i7e /Manufectured Homes not assessed as Real Pruperty Must file dunng fhe twelve (12) rtwnfhs
before March 31 of each year the deduction is srought.
See reverse side 7of a�A'ifional instructions and oaalfications. _ ..,.,,
��� i
:ed vaNe d real Wo�ertY as of
i,�[�
If ro, what Is his / her e�mU share of intefest?
mU
If rwne on'emtl
rtrortgagee or contraa uller
I$ 3� �-c�oo .(� c�r-o a6 I Reoofd number
UWebtedness unpaitl as of Mwlgage I Contrac['u�deMedness unpald as of
� r. _ — Oate of aPPG�tim
mm�ag� w mntraG seAer (numbPi end sveef, cRy, state, aM LP coda)
Name ot assignee w oiher ovmer or hdder ot rtartgage
AOtlress o1 asstignce (number antl slree4
Dces applipnt own property in any oNei
ca,uy �� i�aa�aa
❑ Yes
DetlucUon approved in ihe amount af.
If yns. what munl�/? Wh3t Tadlg DiSUV17
No �---__--._
Dra�� er i\'0....e�� C.
other than spouse,
zo_ 2o C:lr(1 �r�. .... a:ls�.....
i nN�Wditw _ � I l `� � " "� • •
Auditor
Remrder
Page number
res u r+o
Is ihe P�PertY in questim: MnuaM Pssesse0
] Real Roperty � Armually Assgsed
hbble Hm�e (IC 6
Has ih¢ tleduUion Eeen re9ueste0 on PropertY
rwa�nyPan n .,__ n
� I �—
�Y. Yee�)
I IWe cerGf�.u�er the p§nalry of perjury�at the above and foregoing infortnalion is We end cortect and Nat ffie applipnt is a resident of Indiana and
owner / wntract buyer of the a(oremerrtio ed property on date applicalion is filed.
(orne/s /uD Pe ) • Date (month. daY. Y��
U
Fllresident ofappf�nt4num6erandsLee4�1! .�d �FCOde)
S k �I l.0 �-1
Person au Dy duly executetl of Attomey or by IC 61.7-12-0.7 �'ate (rrronth, Oay, ysa�
Pdtlress of autlwr¢ed person (number arM sbee; rily, sble. and LP mde) .