HomeMy WebLinkAboutMortgage_Robb (7)"•n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
� FOR DEDUCTION FROM ASSESSED VAL4JAT�ON
State Form 437U9 (R8l 2-07)
�' � Presoibed by Department of Local Govemmml Fi`ance '�
File Markx ��
INSTRUCTIONS:
To be filed in person or by mad with the CountyAud'dor d the county where the propeRy is located �U L Q S Z� � a
Fdo�g Dates: 7) Real Property: Dunng the 72 months before June 77 W the year fhe deduction is to be eReUive.
2J Mobile Homes assessed under IC 6-7.7-7: Behveen January 75 and Maich 2 0/ fhe year tl�e deduttion is-to�e eHec�q�
See reverse side /w additional ins6uctions arnd qual�cafions. ����' �'�
6185$I� 80FJFITY {�inite_A ti --�
�Aool�er w mnlladhuver - sea re an rererse sde) �
L�SIr.T^
� G�
� m6er/leg criptian
_, _ /�a -Qoa.
,.��. ��,��,.��
airrenl yr.ar
If n� what is his I her ezacl share of interesl?
If� m record is tlifterent than ihal W applicant, iridi�
Name af mortgagee or conUacl seller �
AdOress of rtrortgagee or oonUati seller (number an
Name of assignee w olher o.vner w hdder o1 mut9e9e
Address of assignee (mimber aiM sfreet. city, sfate. ana
Oces applicaN wm poperiy in anY other
counry in Indiana?
❑Yes ❑ No
Deduction appmved in ttie amaunt of:
p � ��
SivreW re af CaunN Autlilor
tity, Stafe, aJM
If yes, whal munf/.�
0
Remy number� Pa �urr7ber
-O� Cii i: (i o 0
as ot Marrh 1, Is ihe appGpnt Ihe sde legal or equitable oxncY7
7 ❑ Yes � No
with someone Wier ihan spousa,
!
Wlqt Taxing Disiric
COUNTY AUDfTOR
2p _ 20
Caunty
he poperty in quesGOn:
Real Pr4perty ❑ Mobile Home QC 61.1-7)
Dra���ei- NO °2.c1Q•�'•3/g•�—
C.11'(1 �Q . .....................
20— � 20—
yea�
1/ We certify under the penalty of perjury ihat the above and foregoing information is true and corred and that the applinnis was I were a resident of
Indiana and owner of the tioned property on March 1, 20
`' SignaUUe (owne/s l�dl nartre //��,� Dare (monN, day, year)
X� atlent address of applicant (numbe� and s4ae7. cily st d LP mde)
2 , s n� �� � �O
� Pason aNlqr¢ed by duly raceatad Power of Altaney or by IC G7.1-12-.07 Date (mmfh. daY. Y�A
Adtlress of aulhoraetl person (number aM s6eet aty. state, arM LP mde)
)