HomeMy WebLinkAboutMortgage_Bachman (2) ��,f � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
: . . y FOR DEDUCTION FROM ASSESSED VALUATION
„°,,,-. ( ) RECEIVED mS •?: h State Form 43709 R14/1-20 Gibson Q�� 2021
--- Prescribed by Department of Local Government Finance
INSTRUCTIONS:To be filed in person or by mail. lv\A C---r
FEB 10 2021 File Mark
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. r�
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property County Auditor
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
ZACHARY M.BACHMAN
Taxing Distric Key number/legal description Record number Page number
n26-12-18-103-000.473-028 0/ I �/-�11fJJC
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 equi able owner?
111,925.00 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: thee;ro,perty in question:Annually Assessed
I�'6tal Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Home Point Financial Corporation FILE
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
9 Entin Road,Suite 200,Parsippany-Troy Hills,NJ 07054 FEB 1 0 2021
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) �t�{u! �"• `%fezt,YW
GIBSON COUNTY AUDITOR
Does applicant own propert in y If yes,what county? What Taxing District? Has this deduction be requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes o current year? Yes ❑No
A person is not entitled t this deduction unless the person has a balance on the person's mortgage or con act 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 Jl r" County s^ Date(month,d year)
MJ , 1 1 't 1
I/ e certify under the penalty of perjury aT the above and foregoing information is and correct and that the applicant is a resident of Indiana and
ner/contract buyer of the aforementioned' propertyty on date application is filed.
gnature(owner's full name) �fi�� Date(month,day,year)
��""� ✓ January22,2021
Fu esident address of applicant(number and street,city,state,and ZIP code)
1004 S Hall 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)
January 22,2021 -
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 CONTRACT INDEBTEDNESS
Name of applicant ' Na e of mortgagee contract seller
ZACHARY M.BACHMAN FILL,. `" 1 l._ o ± �YxiU ,
Date filed(month,day,year) Amount of indebtedness Taxing District_ I rn
2• O. 2021 (D rz.
FEB �10 2Cl2�z5.00
Key number I legal description '' '
26-12-18-103-000.473-028
�i a �Z\ _ i ' o
Signature of County Aud' r/C my Rec der /J �!+- Date(month,day,year) o SL,
VWC C. GIBSON COUNTY AUDITOR �,..SQ,/�' 2 , Ln '
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