HomeMy WebLinkAboutMortgage_Romans ^*E�; STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year/d ' ` FOR DEDUCTION FROM ASSESSED VALUATION
71 State Form 43709(R11 6-09)
RECEIVED Gibson Princeton 2022
sit..
Prescribed by Department of Local Government Finance
�.�---� -� MAR 3 0 2022
INSTRUCTIONS: I I p n,_ \'� ( •�1/ File Mark
To be filed in person or by mail. �w"t 1
Filing Dates: 1.) Real Property: Must be completed and dated in the cale dar year for which the deduction is sought. Form 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. Q 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) Qn'1
' Nicholas Logan Romans C�l�
T� � ���Ung District Key number/legal description Q '3 Record number Page numberp
rL *LYNCH 2ND 113/114 PT ��~ _✓2 GO -000 r�OZ '2- '20 G,
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 of date of application legal or equitable owner?
* $0.00 *$0.00 *$164,900.00 ❑x 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
0 Real Property 0 Annually Assessed
Name of mortgagee or contract seller
F L E D Mobile Home(IC 6-1.1-7)
* Rocket Mortgage,LLC
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
* 1050 Woodward Ave.,Detroit,MI 48226-1906 MAR 3 0 2022
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) Ad if4.fI Z. ..r�< n.)
GIBSON COUNTY AUDITOR
Does applicant own property in any other/ In yes,what county? What Taxing District? Has this deduction been r quested on property
county in Indiana? !J/ for current year?
0 Yes No Yes 0 No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County AuditorVI`J�l—4f S County /7. Q*el Dat q. ntOh gy,y� '
VIA
I/We certify under the penalty of perjury that the above and foregoing information is tru d correct and that the applicant is a r s`iddentntCoff Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name) �� Date(month, day,year)
03/15/2022
Full resident address of applicant(number and street, city, state,and ZIP code)
* 812 E. Evans Street,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)