HomeMy WebLinkAboutMortgage_Bruce (5)N• "•'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
aa_,� 4 FOR DEDUCTION FROM ASSESSED VALUATION
�'• � StateFwma3709(R10/17-08) GibSOn ;c��
�O� � Presmbed by Depanment of Local Governmem Finance
INSTRUCTIONS:
To be filed in person or by mail wifh the CounryAuditor oltha county whe2 the pmperty is locafed.
Filing Dates: 1) Real Pmperty: Musf file dunng the year for which the deduttion is soughf.
2) Mobde /ManufacNretl Homes not assessatl as Real Property: Must file tlunng the fweNe (12) months before
fhe deduction is sought.
See reverse side for addifional insimctions and qualificafions.
ppbranl (owner w wnUaU Duyar �
Randy L. Bruce
Columbia
Assessed valie d mal praperty as of
MarN 1, artem year
M RvBSB
26-74-30.200-000.101-006/A Pt of the NE Qtr. of the NE Qtr of Sec. 30
If no, what is his / her ezad share o/ interest?
If name on recorE is Cifterent than Nat
File Mark
NOV 2 6 2012
Mortgaga / Contraa inCebtadness unpaW as of Mortgage / ConVaG intle6tetlness unpaid as ot Is Ne appliwnt tha mle
March 1. curtent year date of appliration legal or equitaEle owneR
5718,500.00 ❑x Yes ❑ No
Name ol mortgagee w conVad seuer
Hentage Federal Credit Union
Address of moM1gagee w mnVact se0er (num0er and street, ciry. stafe. arH ZIP coda)
5388 Old State Rd. 66 Newburgh, IN 47630
Name of assgnee or oNer owner or holtler o/ rtrortgage
of assignee (numoe� antl s1reeC
4cant own property In anY i
IrWiana?
n Yes
sfafa.
No
yes.
If ownetl vnN someane oNer Ihan spouse, intlifata wiN whom
Is Ne property in Question: MnuaOy ASSessed
� Real Property ❑ MnuaOy Assessed
4Vhat Tazing Distnct9 I Has Nis tleCUClim Deen reQUested on Oroperty
forcurteniyea(.�
❑ Yes ❑ No
COUNTY AUDITOR
DeGuction appmveC in Ne artrouN of:
20 20 _ 20 20 _ 20 _ 20 20 _
Synamre of CounryAWitw Counry I Date (monN. tlay. yea�
I/ We certify under the penalry ot perjury that the abave and foregoing infortnation is We antl cortect antl that the applicant is a resident of Indiana and
owne ntract buyer of the aforementioned property on date application is filed. �
Sig : r e/s. neme Date (rtra+M, day, yea�
i vosnoiz
Full r sident aEdress t appliwnt (numEe�anE streef, city, slate, antl ZIP code)
2659 South 1250 East Oakland City, IN 47660
Person au;horrzed by tluly exewted Paxer olAttwney or by IC G7.1-12-0J Da:e (rtwnN. tlag yea�
Address of autMraed person (nvm0er and ureef, ury, siate, arM ZIP code)