HomeMy WebLinkAboutMortgage_Powers (2) d. r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township 4L2014 Year
- t FOR DEDUCTION FROM ASSESSED VALUATION
: State Form 43709(R11 /6-09) 51
a:z Prescribed by Department of Local Government Finance
INSTRUCTIONS: SEp 03 ;r.,-
To be filled in erson or mail. '
P by Form filed`'tvlth:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sou t.
Must be tiled with the County Auditor or County Recorder of the county where the property is/oc QSO County Auditor
on or before January 5 of the immediately succeeding calendar year. NCO JN County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the
county where the property is located during the twelve(12)months before March 31 of each year the AuOITOR
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer see restrictions on reverse side)
Rosemary Powers
Taxing District Key number/legal description 26-11-02-300-001.548-027/2467 W 100 N, Re uprger� PaL'%rua'53 1
Princeton, Indiana 47670 ( �t � (�
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 application legal or equitable owner?
$0.00 I 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
(I Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
VanDyk Mortgage Corporation
Address of mortgagee or contract seller(number and street city state,and ZIP code)
2449 Camelot Ct. SE, Grand Rapids, MI 49546
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 If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ Yes O No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
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 property on date application is filed.
Signature(or r's-full name) Date(m n ,day,yea
re:,aac a-7/I
Full resident dress of ap i nt(number and street,city,state,and ZIP code)
2467 W 100 N, Princeton, IN 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)