HomeMy WebLinkAboutMortgage_Robertson (2)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
� ���� �R,,,�> v
�,,,, Fresaitea M�aan�^� ot �od Govemmem F�nance ile Ma�k
IN5IRUCT70NS:
To 6e filed in F� ��:
person w by mail with the CowtyAUditor or Counry Recorder o/ fhe county wh�e is located.
FiBrg Dates: 7) Real Property: Must file durmg the year for which the deduclion is wught. ct�R O�Q � Counry Auditor
2� Mobde / Manu(actured Homes rrot assessed az Real Property: Must h7e dunng the twc��[12yrr�� ❑ ��ry R���
before Mamh 31 of each year the dedudion is swyht.
see reverse sfde ro. adaa;ona� rnshwions and yua�ificarlons. ,j!
MP�� ( or 6uyer- see restrictions m�e sitle) �f •, �
' �` 7�N'iY AUDITOR
1 istric{ Key nunEer legal desaiDtian Remrd numbrl P�wmbel
a �-�a -�5- �3a�/-ooa. U 9 �-o�
Ase� ra4n dreal7oD�Y as d Mort8a9a! Contract'vitleMeO�resa unpaid as N Mor(qage I Contrao udebteCn¢ss �m7� as d Is Na e00�t tlro sde
Mard� 7. anmt 7ear MarUG7, w/_rtrnt 1L'���{ date of appfrc�atbn kgal a WW�e �
D V "7V �C�v —r' NO
tt ro_ whal k hit I Mr erar2 sture of inteRSt9 tl awned with iomeoro dhm Cnn spouse. tr�Gmie wGh ✓'
�
��
�a��a��
naaress m assynm (�unmer arK
� o��� ��� �
Epfll bMll (NOOCfCJ Y18IlY MAGf
Intlena? ❑ Yes
DeduGion app'o.ed'o�
�; �
rRy, sfa7e, and LP catle)
If yes. wfiat
COUNTYAUDROR
_ "� �Ql�•••••..•
_-�i��`,�t ti0•••
�'�.,.��..$L•,•••"'
- Card ��' � � � Yun�'_-
� $1.,�� `�� ��'
kias N's detluoion Ocen reQUesOM m Wope+ty
��tl� ❑ Yes ❑ No
2p_ 20_ 20_ 20_ 20_ 20_ 20_
Sig�adce d Camb AuOitor Caunry Date (rrnnN. daY. Y��
I/ We certify urWer Ne penalty of pe�ury that ihe above arW foregoing intortnation is we and correct and Nat the apptirant is a resident of IMiana and
ovmer I contract DuYe� of the aforeme�rooned property on date aPWicabon is filed.
e:..,�...cu,,.....t nn.,e,.�.i Date (rtmN. deY.Y�A
J
ay� py d�yy ¢xecytetl porrl p! Attort�ey or Dy IC 67.7-12-0.7
� of autha'ved D� (numOaranO sfreeS �1: sfafe. arM ZfP mde)
Lia
—J'