HomeMy WebLinkAboutMortgage_Booker ^'r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County hi ear
. ] FOR DEDUCTION FROM ASSESSED VALUATION
S, State Form 43709(R12/6-1 a) Gibson n to
\�;,,, Prescribed by Department of Local Government Finance
INSTRUCTIONS: Flp�6 a.
To be filed in person or by mail. Hr o 'filed wi
Filing Dates: 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 County Auditor or County Recorder of the county where the property is ❑ ; n fy 1 •
located on or before January 5 of the immediately succeeding calendar year. II •,n%}. ni'ecorder
2) Mobile/Manufactured Homes not assessed as Real Property Must rile with the County Auditor of the Gig fN • x Is s
where the property is baited during the twelve(12)months before Mach 31 of each year the deduction is song— .
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side) •
Jeddidiah D. Booker and Phoenix D. Booker
Taxing District Key number/legal description Record number Page number
Princeton 26-12-07-304-002.542-028 a-o l - 0
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the appliiant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
175266.00 El 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 Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Caliber Home Loans, Inc.
Address of mortgagee or contract seller(number and street.city,state,and ZIP code)
3701 Regent Blvd., Irving, TX 75063
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 jny If yes,what county? What 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,yew)
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 property on date application is filed.
Signature(owner's full name) Date(month,day,year)
L D r. y/ /2•
F resides address of app" licant number and street,city,state.and ZIP code)
18 E Monroe St., Princeton, IN 47670
Person authorized by duty 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed 510,000.