HomeMy WebLinkAboutMortgage_Hagen „}. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C unty Township I Year
a' •” r� ^ FOR DEDUCTION FROM ASSESSED VALUATION ,�(.�b
w 2022
{ syT i,' State Form 43709(R14/1-20)
—..,. V Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filled in person or by mail. Fo f d with:
Filing Dates: Form must 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
and payable. County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Amanda M. Hagen
Taxing District Key number/legal description 26-13-24-100-000.173-006/1530 S 1050 E Record number Page number
Q
0 C Oakland City, Indiana 47660
26-13-24-100-000.173-006 -i()
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the ap e thewoer?
sole
assessment date,current year assessment date,current year date of application g qu tabl
$121,111.00 ❑Yes ❑ No
If no,what is his/her exact share of interest? LuI!IL
If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: /� Is t e perty in question: Annually Assessed
((( T 0 eal Property 0 Annually Assessed
CMobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller M'4y
Mortgage Masters of Indiana, Inc. �s s"
Address of mortgagee or contract seller(number and street,city,state,.. ZIP code) 2022
51 N. Cross Pointe Bvd.,
nsvile, IN
NOam of assignee or o herrlowner or holder of mortgage5 —vrG/BSQ
Address of assignee(number and street,city,state,and ZIP code) Y�Un "'?
What TaxingDistrict? Has this deduc-onrequest If yes,state amount of
Does applicant own property in anyIf yes,what county? on property for deduction
other county
in Indiana? 0 Yes 0 o current year? �� Yes No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co,t -ct indebtedn s 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 20 20 20 20 20
Signature of County Audits county Date(month,day,year)
\Ir
I I We certify under the penalty of perjury that t 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. Date( onth,day,years
Signat own full nam et Z-9„ 2
Fu resident address of applicant er and street,city,state,and ZIP code)
1530 S 1050 E, Oakland City, IN 47660
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)