HomeMy WebLinkAboutMortgage_Beadles (3) �snm, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
� FOR DEDUCTION FROM ASSESSED VALUATION
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gO2�w� t` State Form 43709(R14/1-20) Gibson Q2�
16 Prescribed by Department of Local Government Finance
INSTRUCTIONS: To be filed in person or by mail. (R File Mark
����� Form filed with:
Filing Date: Form must be completed and dated in the calendar ear for 'ch t e deduction s sought. Z County Auditor
Must be filed or postmarked with the CountyAudito or Coun ecorder of the county where the property is
located on or before January 5 of the calendar year in which the property taxes are first due and payable. El County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Timothy A. Beadles and Cynthia J Beadles, husband and wife
Princeton 26-12-18-302-000.151-028 `)( `1-0 'g q I
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?
$96,500.00 I2Yes 0 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: i th 1pr berty'n question:Annually Assessed
F IL151 .-a?erty
erty ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Regions Bank d/b/a Regions Mortgage DEC 1 6 2020
Address of mortgagee or contract seller(number and street,city,state.and ZIP code)
2050 Parkway Office Circle, Birmingham, AL 35244
Name of assignee or other owner or holder of mortgage .
Address of assignee(number and street,city,state,and ZIP code) .
Cs
COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio bee equested If yes,state amount of deduction
other county on property for es ❑No
in Indiana? ❑Yes ®No current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c ct 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 l Date month.day,year)
"Syjen
SAA-N
I/We certify under the penalty of perjury that ve and foregoing information is 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)
,?�� a / ,^1 �----' 10/21/2020
Full resident addWWss of applicant(number and street,city,state,and ZIP co )
1603 Boulevard PL, 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)