HomeMy WebLinkAboutMortgage_Dawson (6) '� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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y ' :.. FOR DEDUCTION FROM ASSESSED VALUATION
1� 1;• - `' State Form 43709(R11 6-09) Gibson Princeton 2020
Prescribed byDepartment of Local Government FinanceiTe
RECEIVED
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INSTRUCTIONS: I i*I 11 ktC- DEC 0 4 2020 File Mark
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. or filed with:
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. County Auditor
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the ❑ County Recorder
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)
* Colton Riley Dawson
Taxing Distric IQ Key number/legal description Record number Pagbm ler
* �ZU ` * PT NW 18-2-10 1.0774 AC 2� j2�10 Ib�'002_104 ' .i -O
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as o, ate of application legal or equitable owner?
* $0.00 * $144,337.00 * $0.001L/yi 33`7. 0 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
EI Real Property ❑ Annually Assessed
,,—.1 ,Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller Fi ` t
* Plaza Home Mortgage, Inc. �___4
Address of mortgagee or contract seller(number and street, city,state,and ZIP code)
* 2 Pierce Place Suite 1810, Itasca, IL 60143 DEC 0 8 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street, city,state, and ZIP code) h.;°—;>1`-...�
Does applicant own property in any other In yes,what county? What Taxing Distnct9SON Haas t is aeNTI du fionIbet h requested on property
county in Indiana? for current year?
❑ Yes ❑ No Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of: -
20 20 20 20 20 20
Signature of County Audit Mi ih C38
Coun 1_ 0 Date�mon§dad yeah „
I/We certify under the penalty of perjury that the above and foregoing information i ue and correct and that the applicant is a resident of Indiana and
owner/ intact buyer of the aforementioned property on date application is filed.
Si (o�ner's,�iy11 name.,
,� — Dat (month, day,year)
`ull resident address of applicant(number and street,city, state,and ZIP code)
* 205 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)