HomeMy WebLinkAboutMortgage_Walker (2) ,
�;f="'go., STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e--,- 'i) ► FOR DEDUCTION FROM ASSESSED VALUATION P �j'�1
- '_ - �` Gibson 42atoka. . 2019
' State Form 43709(R13/10-15)
C .4!;-.".�' Prescribed by Department of Local Government Finance
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File Mark
INSTRUCTIONS: Form filed with:
To be filed 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 instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Devin Walker,
Taxing District Key number/legal description Rec number Page er
V lion, 26-12-18-103-001.828-028 Ol
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the ap rcant the sole
assessment date,current year assessment date,current year date of application leg�alof equitable owner?
130,700 116,604.00 Eq'Yes 0 No
If no,what-is his/herexact 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 property in question:Annually Assessed
eal Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Quicken Loans Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) I L L.4 D Woodward Avenue, Detroit, MI 48226
Name of assignee or other owner or holder of mortgage SEP 19 2019
•
Address of assignee(number and street,city,state,and ZIP code)
GI
) . 4+ ia
CO NY Alm!roR
Does applicant own property in a If yes,what county? What Taxing District?- Has this deductionbeen BSON steep it yes,state amou t 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(m nth, ay,year)
I/We certify under the penal of perjury th. •-=••ve and foregoing information is true and correct and that the applicant is a esident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
• ature( wner's full name) Date(month,day,year) .
09/11/19
Full resident address OM-pi) ic and street,city,state,and ZIP code)
234 W Makemson Ave, Princeton, IN, 47670
Person authorized by duly 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$10,000. - • 42804