HomeMy WebLinkAboutMortgage_Robinson •_,•o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township I Year
FOR DEDUCTION FROM ASSESSED VALUATION
State 0.
te Form 43709(R13/115) � �
• Prescribed by Department of Local Government Finance
INSTRUCTIONS:
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. CC[[QQ O 3 O r
Must be filed or postmarked with the County Auditor or County Recorder of the county where the propFryR3 a ti2LI County Auditor
located on or before January 5 of the immediately succeeding calendar year. . Co • y Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the c: ry
where the property is located during the twelve(12)months before March 31 of each year the deductio '3!iv- onrjj,
See reverse side for additional instructions and qualifications. QIDSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Randy L. Robinson and Angela D. Robinson
Taxing District Key number I legal description Record numb - Pa aceurr r
Johnson 26-18-36-200-002.715-024 o%�J
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the s e
assessment date.current year assessment date,current year date of application legal or equitable owner?
$346,243.00 ❑ 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
O Real Property ❑ Annually Assessed
_ Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract sever
German American Bancorp
Address of mortgagee or contract seller(number and street,city,state.and ZIP code)
PO Box 360, Jasper, IN 47547
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant awn property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes ❑No current year? ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 I 20 20 20 20 20
Signature of County Auditor 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 of toned properly on date application is filed.
- towne.'s full nil'i Date(month.day,year)
��a
Full resident address of applicant(number a.__.•e_at.city sate.and ZIP code)
715 W. Brayden Dr, Haubstadt, IN 47639
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-19; Date(month.day,year)
Address of authorized person (number and street city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S 10,000.
. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
-c"): FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13110-15)
- Prescribed by Department of Local Government Finance _ -
INS7RUCTIONS: _ File.Mark
To be filed in person or by mail. MA I pp ' !)44 :
Filing Dates 1) Real Property.Must be completed and dated in the calendar year for which the deduction is sought
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is s ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. I. ._,•-!' rrn Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the r '�•n'1�•
where the property th
is located during the twelve(12)months before March 31 of each year the deductrdt-t -.?Z LC• • ' L!T
See reverse side for additional instructions qualifications. //� /} ilk
Applicant(' 9 tray see i on nwe srdey �h,. 4 /
T- •- r�rl "Key number I - Record number Page nu r
c .� - /I G-goo pod Cs-- OaV 07o / a/ 7j
-,value of real property as of Mortgage I Contract indebtedness unpaid
-7r... -nerd date,current year assessment date,cement year as of Mortgage pljc ti Contract indebtedness as of Is the applicant e the sner
legal or equitable owner?
3 ❑ Yes ❑ No
it no,what is his I 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
eat Property ❑ Annually Assessed
Mobile Home(IC 61.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
I4
Drawer NO 4261 g /
Mat Taxing District? Has this deduction been requested If yes,state amount of deduction
p on property far
Card NO. Qq current year? ❑Yes 0 N
has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorders omce(uuruorng any nome equity tine or aeon mat is recorded in the county recorder's office)that is the basis for the deduction. .
COUNTY AUDITOR
Deduction approved in the amount ob
20 20 20 20 20 20 20
Signature of County Auditor 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 f contract buyer of the aforementioned property on date application is(fled.
Signato e Date(month,day,year)2�\A
, Full r i ddress
of applicant(number and sheet dTy•state,and ZIP code)
1/5 v- `i)tayden istrif - i✓ ezt-7 3';
Person authorized by duty leaned 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000. .