HomeMy WebLinkAboutMortgage_Richeson (4)Qy "'�.o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE n T ns p Year
:e__,_ = FOR DEDUCTION FROM ASSESSED VALUATION /
• State Fortn 43709 (R71 / 6-09) i 6� PrinCEton 2073
•'��'+ �resrnbeC by Department of Local Govemment Finance
ile Mark
INSTRUCTIONS:
To be lled in person or by mail. � eled with:
C '�•
filing Dates: 7) Real Property: Must 6e wmplefed and dated in the calendar year tor which [he deduclion is sought.
Musi 6e filed with the Counry Audito� or Counry Rewrder o7 the counry where the pmperry is located Counry Auditor
on or before January 5 of fhe immediatety succeeding calendar year. r�qg�N COUNT AICD,TO�i unry Recorder
w
2) Mobile / Manulactured Homes not assessed as Real Properry: Must file with the Counry Fuador o/ the
counry where the proper.ry is located dunnq 1he fwefve (12J months 6efore Mamh 37 of each year fhe
deduction is sought.
See reverse side (or additional instruUions and qualifica(ions.
Appicant (owner or con;raa buyer - see resfriciions on reverse side)
Trevis J. Richeson
Ta�dng Distria Key number! le9al tlesaiplion R d number Pa e numher
Princeton 2612-17-101-001.327-028 p�o� �
AssesseE rakre d real propellyas W Mortgage I Con•uad i�deb,edness unpaid as ol Mortgage / Convarl uWebteGness unpaid as of Is ihe appliwnt Ne sole
Mardi 1, airtent year March 7, aRent year date of apd�� legal w eQUitable ovmeR
108,900 70,408 ❑� Yes ❑ No
If no, wtut is his / her exact share ol imerest? I` amed wiih somea�e ahu Ihan spouse, indirate v.iN whan
If name on recwC is df.`erem Ihan Uwt of appliqnt, indicate beiow. Is Ne property in quation: Annualty Assessed
❑� Reai Property ❑ MnuallyASSessed
Moble Home (IC 6t7-7)
Name of mongagee or tOnfrdct uller
Mortgage Masters of Indiana. Inc.
Address of mongagee w mnVact se0er (number and slreeL ci,y, ste;e. and ZIP code)
7144 E. Vrginia St. Evansville, IN 47708
Name of assignee or oNer ov.ner or holder of rtart9a9e
AtlEress of auignee (numDer aM slreeL ciq: state, and ZIP code)
Dces ap„Nicani avn property in any oNer If yes, what counry? L1Tai Taring Distna? Has tNS daduUion Deen requested on property
cnunry m Intlana? for wrrenr yean
❑ Yes Q No ❑ Yes ❑ No
COUNN AUDITOR
Dedudwn approved in Ne artwunt of:
20 20 _ 20 20 20 20 20 _
Sigriature of Caunry Audrtw Counry Date (r.anth, day, yxa�
I I We cerli(y under ihe penalty of perjury that Ihe above and toregoing infwmalion is We and wrzeU arW Ihat �he applirant is a resident of Indiana and
owner / con�raU buyer of ihe aforementioned property on date application is filed.
SignaWre ( fs lu0riame) Date (rtanlh, tlay, yxar)
� 10/17l2012
Pud resbent aECress of apyirant (number aM streei, crty, sfata, aM ZIP code)
1019 S. Adams St. Princeton, IN 47670
Person auttanzed by Culy exewted Power of Attomey or by IC 6L1-12-0.7 Date (rtanih, tlay, yea�
Atltlress ot auNOnzed person (number end ureet, crfy, siate, arid ZIP code)
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