HomeMy WebLinkAboutMortgage_Meyer (7) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
'at . FOR DEDUCTION FROM ASSESSED VALUATION
\,, State Form 43709(R12/6-14)
\ . Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. Form fled with:
Filing Dates: 1) Real Property:Must be completed and dated in the ndar ea for h ei'— tion is sought.
Must be filed or postmarked with the County Auditor or oun ecorder o e county where the property is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Prope/ /s'filtLgn p County Auditor of the county
where the property is located during the twelve(12)months Herald arc o ach year the deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Meyer, Ashley A. CIBSON COUNTY AUDITOR
Taxing District Key number/legal description Record P n .�1}
Princeton 26-12-18-103-001.062-028/McKaw Sum 44/45 PT o Q 1
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appli nt the sole
March 1,current year March 1,current year date of application legal or fable owner?
55,900.00 0.00 79,489.00 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 property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Top Flute Financial, Inc.
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
123 E. Grand River Ave., Williamston, MI 48895
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 i any If yes,what county? Vvhat 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 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
I 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 properly on date application is filed.
Signature(owners AV name) Date(month,day,year)
0. r 21 015
Full resident address of 'icant(number and sne It city,state,and ZIP code)
Person authorized by duly executed Power of Adomey 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.