HomeMy WebLinkAboutMortgage_Glover� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count I 7ownship Year
e� '= FOR DEDUCTION FROM ASSESSED VALUATION
•'°�.
�`�� State Fortn A3709 (R11 / 6-09) Gibson Princeton 2012
" �' PrewibeE by DepaNment o/ Local Govemmen� Finance
INSTRUCTIONS:
File Mark
To be filed in person or by mail. Fo 51etl
Filing Dates: 7) Real Property: Must 6e completed and dated in the calendar year for whicb the deduction is sought.
Mus16e filed with (he CountyAuditor or County RecoNer o7 the county where the property is locafed itor
on or be/ore January 5 o7the immediafety succeeding calendar yeac J L� ry Recorder
2) Mobile /Manulactured Homes not assessed as Real Property: Must file with the CountyAuditor of the
county where the propeRy is located dunng the tvie/ve (12J months before March 31 of each year the
deduction is soughL C . �, �
See reverse side 7or additional instructions and aualificafions.
Applican� (owner oi conf2ct buyer -
Melanie B. Glover
Tawg District
Gibson
Assessed value M real propery as of
�arrh 7, wrtent year
' 17,300.00
see res[rictions on reveroe sitle)
Key numher / legal tlescriptan
26-12-18-707-000.036-028
Mortgage / ConVacl indebtetlness unpaic as of Mortgage / ConVacc
March 1, cunent year Aate of application
15.000.00 109.782.00
if no, what is Ns / her ezaa share ol inlerest?
If name on reartl is dfferent Man Nat of applicant, intlicace belmr.
Name otmort9agee or conVaa uller
Top Ffite Financial, Inc.
Pddress of rtangagee w mnvaq seDer (number arN stree( riry, sfate.
123 E. Grand River Avenue, Williamston, MI 48895
Name o/ assignee or oNer ov.ner or hdder of mortgage
Nddress o( assignee (numberantl street. cdy, state. an0 ZlPCOde)
Does appliwnt am property in any a�her I( yes, what co
munry in Ind'ana?
❑ Yes �❑ No
Detlutfion approveE in ihe amouni of:
20 20 20
SignaWre oi Counry AuEiWr
GOUNTY AUDITOR
20 20
Coun.y
�'°�vN COUNTY qUDITOR
17ecorE number Page number
s�7a
btedness unpaid as ol Is ihe appliqnt Ne sole �
legal or equitable owner? '
❑� Yes ❑ No
spouse, inCicare xiN whom
Is Ne property in queslion: Mnualy Assesse0
Q Real Property ❑ MnuallyAssessed
Has Nis deduttion been requested on pmperty
iw curtent year?
❑ Yes Q No
20 20
Date (monlh. day, yeaq
I/ We ceNfy under the penalty of peryury ihat the above and toregoing informa6on is true and correci and that ihe applicant is a resident of Indiana and
ovmer / conVact buyer of ihe aforemenUOned property on date appliration is filed.
Fu0 resitlent aEtlress of applicaMynvmbSPend street, city, slate, end ZIP code)
903 S. Robin Sireet, Princeton, iN 47670
Person authorizetl by tluly executed Power ol Momey or by IC Gi J-12-07
Address of au'Jrorized person (number a�M street, riry, sfate, antl
Date (monM, tlay, year)
7/3/2012
Date (monN, tlay. yean