HomeMy WebLinkAboutMortgage_Patterson (3) e%��' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
;e__ 4 FOR DEDUCTION FROM ASSESSED VALUATION
\">,i��� " State Form 43709(R12/6-14)
\1s•' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. Form filed with:
Filing Oates: 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 CountyAuditor or County Recorder of the 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 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 deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restncdons on reverse side)
Patterson, Gabriel
Taxing cet Key number/legal description ReGpOimb?r P�ja bgrco
Princeton 26-12-07-402-000 967-028/Stormonts Add 7 PT .. , 015
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicam a sole
March 1,arrrent year March 1,current year date of application legal or equ' le owner?
69,900 55,067 50,875 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 th roperty in question:Annually Assessed
eal Property ❑ Annually Assessed
Mobile Horne(IC 6-L1-7)
Name of mortgagee or contract seller FILED
Movement Mortgage, LLC
Address of mortgagee or contract seller(number and street,city,state.and ZIP code)
841 Seahawk Circle, Virginia Beach, VA 23452 DEC 2 2 2015
Name of assignee or other owner or holder of mortgage 1
Address of assignee(number and sbee• ty,state,and ZIP code) (!.� /I�-
Does applicant own property in y If yes,what county? What Taxing District? Has this deduction begLIP*:i Li L-444t41,kXtcSQAtick uction
other county „ property for ❑No
in Indiana? Yes No current year? ❑Yes .
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/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 of ryentioped o erty on date application is filed.
ig azure(owners full name) _ (month, ay yeaq
r.
"i 2— I(2- I �617
u residentpddress of appli nt(number and street,city,state,a d ZIP code)
6ncr 6, Yl At. ,.,0.�-(-c� (oQ*-1- F0a,Ac-,\A\Q 1M - �-�
Person authorized by duty executed Power ot,homey or by IC 6-1.1-12-0.7 year)
Address of authorized person (number and street,city state,and ZIP code) / Data(month,day,
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.