HomeMy WebLinkAboutMortgage_Robinson (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
f . 4 FOR DEDUCTION FROM ASSESSED VALUATION
°► t } Gibson Johnson 2019
�� tateForm4309{r'13/1O-15i
r t. Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
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.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is Q C•
ounty Auditor
•
located on or before January 5 of the immediately succeeding calendar year.
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county ❑ County Recorder
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Randy L. Robinson and Angela D. Robinson
Taxing District Key number/legal description Record number Page number
Johnson 26-18-36-200-002.715-024/WATER TOWER PLACE 29 2.0"°I , 43 6 0
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$0.00 ' $377,000.00 El Yes 0 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
-❑x real -..---: ;-- ■ -Annually Assessed--
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller __ �
Heritage Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 2019
5388 Old State Road 66, Newburgh, IN 47630 NOV ��}
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
GIgSON COUNTY AUDITOR
If yes,what county? ' What Taxing District? E-'9 tl` 'educ-ti n en resueeted If yes,state amount of deduction
r3 "^•�D ❑Y LrV,J(N 7 'ent year? ❑Yes [1]NO
A person is not entitled to this deduction unless.the person has a balance on the person's mortgage or contract indebtedness edness that is recorded in the county
recorders office(including any home equity doe of credit that is recorded in the county recorder's da office)that is the basis for the deduction_
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 2j0 20 20
Signature of County Auditor QQ County Date(month,day,year)
(Y) Gibson I I• if• t I
I/We certify under 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 p on date application is filed. _
eSignatulet(ewner.'safai` e ' Datet(moni17,45yiyear)m
Full resident address of applicant(n ber and street,city,s te,and ZIP code) •
715 W. Brayden St., Haubstadt, IN 47639
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)
The penalties for pert utty can include imprisonment up to two and a half years and a fine nor to exceed SI 0.000.
etre.,11s,rests I I I\II+ e•T ATr1111 r\IT/1r IIIfAr1T/,A e• Am "AkITEI A"T.1\Ir1CoTCrIAIGQC