HomeMy WebLinkAboutMortgage_Malone .it--m STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Igwnship Year
-1 - 1-;\ FOR DEDUCTION FROM ASSESSED VALUATION ��
i'• State Form 43709(R13/10-15) Gibson --Pstokt 2019 •
`+: r' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: Form filed with:
To be tiled in person or by mail.
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the County Recorder
property is located on or before January 5 of the immediately succeeding calendar year -
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
Taxi eis Ct Key number/legal description • Record n 4er Page n pgr
Y 11 26-12-07-204-001.085-028 zg SS
Assessedvalue of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpa a of Is the applicant the sole
assessment date,cement year assessment date,anent year date of application I or equitable owner?
145,563.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with wh m •
If name on record is different than that of applicant,indicate below: Is e property in question:Annually Assessed
Real Property 0 AnnuallyAssessed
. Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Carrington Mortgage Services,
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1600 South Doublass Road, Suites-110 & 200-A, Anaheim, CA 92806 GT ry
Name of ass •
ignee or other owner or holder of mortgage F I ® ..r' n
•
Address of assignee(number and street,city,state,and ZIP code) : • - - - • . g••8��1dd - _
. _ - . . AU6.26 2019 . - - . . . .
Does applicant own property in ny 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 III JJJ No current year? ❑Yes u,
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or corsiescistotAtivrif m pp s*n 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 de uc r "V rR�
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20
Signature of County Auditor ��� County Date month, / m
I/We certify under the penalty of perjuryv h the a - nd foregoing information is true and correct and that the op It
is
a r s dde\nt of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Si natur wnets to na ) Date(month,day,year)
08/20/19
Full resid address of applicant(number and street,city,state,and ZIP code)
516 E Brumfield Ave, Princeton, IN, 47670 -
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
I
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 pot to exceed$10,000.