HomeMy WebLinkAboutMortgage_Peek (3) '=.t►, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co my Township Year
g ��ccdd `i: FOR DEDUCTION FROM ASSESSED VALUATION � ^
i State Form 43709(R14/1-20) l ,' �'� Q / /9 2,G?Z2,,.
s1e Prescribed by Department of Local Government Finance RECEIVED `t^-��
� n.w File Mark
INSTRUCTIONS: To be filed in person or by mail. 6 "�l F FEB 1 5 2022
X r f Form filed with:
. Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. KCounty 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. County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Peek, Zachary
Taxing District Key number/legal description Record numb Page um be
Princeton 26-12-18-304-000.317-028 PT S 18-2-10 .25A 2 . ��.,
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?
147000.00 ®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: Is the property in question:Annually Assessed
®Real Property it Annually Assessed
FILED Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Caliber Home Loans, Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) ��,
1525 South Belt Line Road, Coppell, TX 75019 FOQ IS 2022
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) C;r '.,,(TAR
GIBSON COUN-'i t ,,..
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio b n requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes xNo current year? Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or n 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 tha 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 �I County ' Date(mo th,d ear)
(� k)a la-K- J o,1 2 1 ' '�,-2
I/We certify under the penalty of perjury t t e above and foregoing information is tru and correct and that the applicant i a resi ent of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Si nature(owner's full name) Date(month,day,year)
1{/ 1/24/2022
�l re1en ddre- of aaa�pli ant(number and street,city,state,and ZIP code)
46 E 150 S, Princeton, Indiana 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 nanalties for perjury can include imprisonment un to two nn,-,=t,,,,a•^---- - '