HomeMy WebLinkAboutMortgage_Moore (12) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
y/�� :il FOR DEDUCTION FROM ASSESSED VALUATION
5i '").1` State Form 43709(R13/10-15) Gibson O'ville 2020
Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
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 filed or postmarked with the County Auditor or County Recorder of the county where the property is 0 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 restrictions on reverse side)
Gerald/Marialisa Moore
Taxing District Key number/legal description Record number Page number
O'ville 26-17-12-102-000.359-022 2020 0260
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
45,000 ❑■ 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
■❑ Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Nationstar Mtf LLC
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
612 W Brummit St, Oville In FILED
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) MAR 11 ZOZO
Does applicant own property in any If yes,what county? What Taxing District? H his dedu tion e crested If yes,state amount of deduction
other county o o e
in Indiana? ❑Yes ❑t No s ❑No
A person is not entitled to this deduction unless the person has a balance on the deb iOE}ld k 1 iJYor M,Tcf edness 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.
Deduction approved in the amount of: �/ r
Lsk tr�� LLL Oo reU
20 20 20_ /j] h it—/ L. j s n /4 /l Go , L% 20 _ 20
Signature of County Auditor /' Date(month,day,year)
3/11/2020
1/We certify under the penalty of perjury that the ab pplicant is a resident of Indiana and
owner/contract buyer of the aforementioned proper
Signature(owner's full name) 01-0 02-U (7 Date(month,day,year)
3/11/2020
Full resident address of applicant(number and street,city,star
316E Pine St., Princeton, IN 47670 41 4- ' LC
Person authorized by duly executed Power of Attorney or by If Date(month,day,year)
A4 (1
Address of authorized person (number and street,city,state, . •
The penalties for perjury can include imprisonment up I /
00-0. r7�
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Gerald/Marialisa Moore Nationstar Mtg LLC
Date filed(month,day,year) Amount of indebtedness Taxing District
3/11/2020 45,000 O'ville
Key number/legal description
26-17-12-102-000.359-022
Signature of County Auditor/County Recorder County Date(month,day,year)
Gibson 3/11/2020