HomeMy WebLinkAboutMortgage_Singer �55 %, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
V.v.,_ �: FOR DEDUCTION FROM ASSESSED VALUATION 028
.F ' State Form 43709(R14/1-20) Gibson 2021
016 Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail. Simpli file/Patti/Bway T 2/19/2021 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
located on or before January 5 of the calendar year in which the property taxes are first due and payable. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Lynn R. Singer
Taxing District Key number/legal description Record number Page num
Princeton 26-11-12-104-001.840-028 2Q 2( g .
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?
$110,461.00 VIYes ❑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
Quicken Loans, LLC FILED
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1050 Woodward Ave., Detroit, MI 48226-1906 Feb 19 2021
Name of assignee or other owner or holder of mortgage Y124;kid W.ii/
Address of assignee(number and street,city,state,and ZiP code) GIBSON COUNTY AUDITOR CB
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on propertyfor
in Indiana? ['Yes ®No currrentyer? Yes El 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 B" 20 20 20 20 20
Signature of County Auditor C County 'Date(month,day,year)
e,.Ia litrafinad Gson 2/19/2021
I/We certify the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signetyre(owner's full name) Date(month,day,year)
�l��- �J 02/18/2021
Full resident address of applicant(numbednd street,city,state,and ZIP code)
1610 W. Brumfield 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)
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 Name of mortgagee or contract seller
Lynn R. Singer Quicken Loans, LLC
Date filed(month,day,year) Amount of indebtedness Taxing District
2/19/2021 $110,461.00 FITtraceton
Key number/legal description
26-11-12-104-001.840-028 CR Feb 19 2021
Signature of County Auditor/County Recorder County Date(month,day.year)
Yea G'son `,t e a 1d 2/19/2021
GIBSON COUNTY AUDITOR CB