HomeMy WebLinkAboutMortgage_Scott (10) ■*•*< STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I Cunty Township Year
(....,'i-r -- FOR DEDUCTION FROM ASSESSED VALUATIONO 2022
.-` -l+ State Form 43709(R14/1-20) File Mark
; ''_ --•r' Prescribed by Department of Local Government Finance
Dais
INSTRUCTIONS: For fi d with:
D To befilled must
in person mail.
Filing Dates: Form be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the County Auditor
property is located on or before January 5 of the calendar year in which the property taxes ae first due ❑ County Recorder
and payable.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Donna J. Scott
(Record number Page number
Taxing District 0 P\S Key number 26-12-18-103-004.425-028 �aoZ� /3e-0
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of(Mortgage/Contract indebtedness unpaid as of lIs ten p quant the
sole
assessment date,current year assessment date,current year date of application legal l Yes 0 No$179,768.00
If no,what is his/her exact share of interest? I If owned with someone other than spouse,indicate with whom
Is t property in question: Annually Assessed
If name on record is different than that of applicant,indicate below: Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
AmeriFirst Financial Corporation, ISAOA,ATIMA
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) "LED
950 Trade Centre Way, Suite 400, Kalamazoo, MI 49002F
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) MAR 2 2 2022
Does applicant own property in an If yes,what county? What Taxing District'? Has is deducti n en requested If yes,state amount of y for deduction
other county ` ( 0 Yes ❑ No
in Indiana? 0 Yes No SOtz GOON Y AU
A person is not entitled to this deduction unless the person has a balance 94 e persons mortgage or co r t indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recordedrecorder's office)that i the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
I 20 20 I 20 I 20 I 20 I 20
20
Signature of Counudit 1County
L 'Ql IN 1.Date(mAnth, �q(
i ar Q��
I/We certify under the penalty of p
that the above and r going information is true and correct and that th apilic9 nt is a resident of Indiana
and owner/contract buyer of the aforementioned pro erty on teapplication is filed. Date(Th mo thda/y year) ^�
Signature(owner's full name) ( 3 f i O /O-0O�ot.
Full resident address of applicant(number and street,city,state,and ZIP code)
1313 Baldwin Ct., Princeton, IN 47670 (Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
Address of authorized person(number and street,city,state,and ZIP code)
_. ,. ----..._.,.....,,,�I,,.+a fmndcnnment tin to two and a half years and a fine not to exceed$/0,000.