HomeMy WebLinkAboutMortgage_Ramirez , ,.
ceR,rsa� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
% � � FOR DEDUCTION FROM ASSESSED VALUATION
". °`� State Form 43709(R14/1-20) Gibson Princeton 2020
Prescribed by Department of Local Government Finance
rare
File Mark
(N TRUCT/ONS: To be filed in person or by mail. Form filed with:
Filing Date: Form must be completed and dated In the calendar year for which the deduction is sought. m County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is CI County Recorder
located on or before January 5 of the calendar year in which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications. •
Applicant(owner or contract buyer-see restrictions on reverse side)
Tabitha Ramirez
Taxing District Key number/legal description Record number Page number
Princeton 26-11-12-204-002.780-028 2020 39 0
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?
$ 80,000 IIYes ❑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: the property in question:Annually.Assessed._ _
pi-IERe roperty ❑AnnuallyAssessedLe:
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller < il,
Mortgage Masters/First Advantage Sep
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 20Q 2
Name of assignee or other owner or holder of mortgage G/ •
es,O
Nc •
Address of assignee(number and street,city,state,and ZIP code) NT), U
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested 9'It 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
Sign lure of County Auditor County Date(mo th,day,year)
jThsk_ f m Gibson �Q\cCCD
I of er'u that the a fore oin information is true and correct and that the applicant is a residen of Indiana and
I/We certify under the penalty p ) ry 9 9
owner/contract buyer of the aforementioned property o ate application is filed.
,29gature_(ownar'_' "e).J �Daf((month,_days yea i
/��I(/j/N/7` /�f0
Full resi ress of applicant(number and street,city,state,and ZIP code)
708 W State St., 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.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRAC KCBDESS
Name of applicant Name of mortga r •ntract Ile )lam
Tabitha Ramirez Mortg e sp' st Advantage
Date filed(month,day,year) Amount of indebtedness Taxing
q ,.O_ e 203 _ $ 80,000 E� VIA e'fon
Key number/legal description S
26-11-12-204-002.780-o 8 e'CGR
Sig ure of County Auditor/County order County Nov ltat pmonth,day,year)
..mil,, C'
Gibson „co-I.' q —�0_ O�CJ ao
G`�suea