HomeMy WebLinkAboutMortgage_Long (8) M n o. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Founty Township Year
efw-' \ FOR DEDUCTION FROM ASSESSED VALUATION
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State Form 43709(R13/10.15) RECEIVED ..SOr1 02-2 2 _
`, a� Prescribed by Department of Local Government Finance
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INSTRUCTIONS: 12P�,1(�,\„ y �4r�(1 j (/_A_}�`1R APR 0 8 2022 File Mark
To be filed in person or by mail. ��v �Sr'� Form filed with:
Filing Dates: 1) Real Property:Muster 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 property is County Auditor
located on or before January 5 of the immediately succeeding calendar year. County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the 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)
Long,Davon Caine
Taxing District Key number/legal description Record numbgr Page nu i b
�. ' g
Princeton 26-12-07-201-002.189-028/NS LOT 5 PT R1 40 2.L 7 Ai
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? {l
48400.00 0.00 152.290.00 Y Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom 1
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
x Real Property 0 Annually Assessed
FILED Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Plaza Home Mortgage.LLC ISAOA
Address of mortgagee or contract seller(number and street.city state,and ZIP code) APR 1 2022
gROR Srrantnn Road.Suite 3t1OO.San Meg,CA 97171
Name of assignee or other owner or holder of mortgage /
tom( a. iACE
Address of assignee(number and street,city,state.and ZIP code) GIBSON COUNTY AUDITOR
Does applicant own prope.% i =ny If yes,what county? What Taxing District? Has this deducti n requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes A No current year? Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or Tact 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)th t 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 County Date(rant .day. ear)
MU �.I JOn I3 2022-
I/We certify under the penalty of perjury that the above and foregoing information is tro a and correct and that the applicant is resid nt of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
ig lure(o rug n ) Dot (month.day.year)
ti 3 to i t --
WI ident ss of applicant(number and city.state.and ZIP code)
405 E Pine 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)
Address of authorized person (number and street,city,state,and ZIP code)
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