HomeMy WebLinkAboutMortgage_Dawson (3) FOR DEDUC IO MORTGAGE S ED ALUAT INDEBTEDNESS Cou J� how Year
FOR DEDUCTION FROM ASSESSED VALUATION fJ j N� ce
State Form 43709(R12/674) Gib n •
'• Prescribed by Department of Local Government Finance t
INSTRUCTIONS: J V tv t o I
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 Ned or postmarked with the County Auditor or County Recorder of the county where the property is . UI .,f - •itor
located on or before January 5 of the immediately succeeding calendar year. l' • sell' Rtn r
2) Mobile/Manufactured Homes not assessed as Real Property Must file with the County Auditor of tti}¢ ,rt C t U NTYx' I t u
where the property is located during the twelve(12)months before March 31 of each year the deduct;9113'h• .
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Angela R. Dawson
Taxing District Key -1 2-/legal description "MC PpggpMb,r�^
Princeton 26-12-17-200-002.569-028 11 (;^)jam.{�"t/`Vt`
Assessed vale 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?
101,530.00 p 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
El Real Property ❑ Annually As-tossed
Mobile Home(IC 6-l.1-7)
Name of mortgagee or contract seller
Hometown Lenders LLC
Address of mortgagee or contract seller(number and street,city.state.and ZIP code)
310 The Bridge Street, Huntsville, AL 35806
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city state.and ZIP code)
Dces applicant own property in any If yes,what county? I What Taxing District? Has this deduction been requested If yes,state amount of deduction
other County on property for
in Indiana? ❑Yes o current year? ❑Yes ❑No
A person is not entitled to his 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
l I 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 I contract buyer of the aforementioned property on date application is filed. �( '{a-�( ���� l� [�
Signatwe 's ll name) �_ e. r��-���/ ^'' V mU 1 Q year)at 3-616-IL IM. �1'M1 IV1� r
Full resident address of plicant(number and street.city,state,and ZIP code)
Angela R. Dawson
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day.year)
Address of at prized 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 510,000.