HomeMy WebLinkAboutMortgage_Rodgers (2) rig. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I jownship Year
a FOR DEDUCTION FROM ASSESSED VALUATION FILE
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State Fenn 43709(R11/6-09) �IH ��
„w/ Prescribed by Department of Local Government Finance !b JJJiii.�..JJJ L
File Mark
INSTRUCTIONS:
• 1
To be filed in person or by mail.
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. Cost Au.-or
Must be filed with the County Auditor or County Recorder of the county where the property is located El
on or before January 5 of the immediately succeeding calendar year. 'I,,, .4,,,„ ;s' Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor 44.06.sO
county where the property is located during the twelve(12)months before March 31 of each yea - -
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
JUSTIN A. RODGERS
Taxing District Key number/legal description Record num r Page nupbec!r� _
PRINCETON 26-11-13-204-002.814-028 CIO I 5/8
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of pcation 00 legal or equitable owner?
CO t.
$ T , I 5.2. 0 Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below. Is the property in question:Annually Assessed
12 Real Property ❑Annually Assessed
Mobie Home(IC 6-1.1-7)
Name of mortgagee or contract seller
KIRKSTON MORTGAGE LENDING,LLC
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
501 CROSS POINTE BLVD., EVANSVILLE, INDIANA 47715 •
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any other /1 If yes.what county? What Taxing District? Has this deduction been requested on property
county in Indiana? L�,�../\ for current year?
❑ yes No ❑ yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 _ 20 20 20 20 20 20
Signature of County Audbor County Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned propert on date application is filed. -
Signature(owners cull n/ f .l.G/ //�; / Date(month.011/ yt'er)0,4 Carr?("///rrrrrr�l??/((��� l!/�• /2013
Full resident address pplicant(number end street,city,state,anjP code)
806 Makemso Avenue,Princeton,Indiana 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month.day,year)
Address of authorized person (number and street,city,state,and ZIP code)