HomeMy WebLinkAboutMortgage_Robbins (2)�•^—�„ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
�' i�.. � FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm 43709 (RN / 6-09)
PreSaibea by DeOartmeni of Lxal Govemment Finance
INSTRUCTIONS:
To be filed in person or by mail.
Filing Dates: 7) Real Property: Musf be completed and dafed in !he calendar yearlor which fhe deduction is sought.
Must be filed wifh the Counry Autliro� or Counry Recorder ol ihe counry where the property is located
on or 6e7ore January 5 oltAe immediately succeeding calendar year.
2) Mobile / ManWactured Homes no( assessed as Real PropeRy: Must fife with (he Counry Auditor o7 the
county where the properry is located dunng !he twelve (72) monfhs 6etore March 37 07 each year the
deduction is soughf.
See reverse side tor additional insbucfions and quali�cations.
Appticant (owneror convact buyer-see restnclions wr revarse vde)
Matthew and Tara Robbins
��CgryMAuditor
0 CI1fQ
Counry Recorder
T' DisVi Keynumber/legaldescriptbn Recordnumber Pagenumber
26(�OS-40.78&004.117-027IPt loc 187, Ice 188, Frac 30.1-10 p2o� o� Q
Asussetl raWe ot real qoperty as ot Mortgage I Contraa i�MeE;etlness unpaid as o( Martgaga / Contrad intleCteErress unpaitl as at Is Ne applicant Ne sde
Mart�h 1, artentyear Ma¢h 1, curtent year date of applicalion legal or equitade owner7
150450.00 0 Yes ❑ No
tl no. what is his / her exad share af interest7 II wme0 wiN mmeone oNer Nan spoux, inCifate wiN wtwm
on
Name of rtrortgagee or wntract se0er
Farm Credii Services of Mid-America
Atltlress of mortgagee ar wnVac� seDer (numEar arM ihee4 �M• stafe, an0 ZIP rotle)
15747 Neely St. Evansville IN 47725
Name of assgnee w oNer owner or IwlCer oi rtqrt[
ACCress of ass5nee (number and svee4 cd}: state.
Ooes apqirant avm property i^ any oNer
counry in Indiana?
❑ Yes ❑� No
20 I 20
II yes, what counry7
20
Is Ne D�DenY � 9uestion: Mnua�y Assessetl
�❑ Real Pmperty ❑ Mnually A55essed
Mobile Home /IC 61.
What 1
�UDITOR �� ��
20 _
•. requested on OroDerty
❑ Ye5 � I
20 _
Date (month, tlay, yea�
20
I/ We certity under Ihe penalry of perjury that Ne above and loregoing infortnation is We and cortect and tha[ the appliwnt is a resident of Intliana and
owner / wnt2ct buyer of the aforemen6oned property on date application is filed.
anature (owneh7ull name) Date (monN, day, yea�
)�. _ —� � i S _ 1118/12
FW resiCent aCEres�eeht (numDer antl sveei, i�ry. sfa:e, ana ZIP wtle)
2500 N Tower Ln Princetan IN 47670
Person auNwized Gy duy esecute0 Pvxer ot Attomey or by IC 61.1-12-0.7
AEtlress of auNOnzeE person (numDararM SfreeS Gry, sfafe, anC ZlPCOtle)
yea�