HomeMy WebLinkAboutMortgage_Long (2) 0 F � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�/11 '�* �i' FOR DEDUCTION FROM ASSESSED VALUATION
NCO. State Form 43709(R11 6-09) Gibson Princeton 2022
Prescribed by Department of Local Government Finance
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INSTRUCTIONS: File Mark
To be filed in person or by mail.
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. Form filed with:
Must be riled with the County Auditor or County Recorder of the county where the property is located 0 County Auditor
on or before January 5 of the immediately succeeding calendar year.
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)
Tyler J.Long . -Zil4 11 -()Le ` O OO-. 4 S3_ fri,
Taxing District 025 Key number/legal description Re*cord number Page numbery
*SWALLOWFIELD#2 10 zq 0 �— OC
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?
* $0.00 *$ Vc3 0, 2i co *$280,250.00 El Yes ElNo
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
El Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller FILED
' Springs Valley Bank&Trust Company
Address of mortgagee or contract seller(number and street, city, state,and ZIP code)
1500 Main Street,Jasper,IN 47546 MAY 2 3 2022
Name of assignee or other owner or holder of mortgage t!
Address of assignee(number and street, city,state,and ZIP code) t y�_���( O4 1�Y ` re4.-)
Does applicant own property in any other In yes,what county? What Taxing District? GI818®Igl€41451143V smilested on property
for current year?
county in Indiana? Yes D No
❑ Yes � No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Countyk Date(month, day,yea
Signat^urne of County Au dor / /'� r
_ t(c�N 5� 3/�
I/We certify under the penalty of perjury that the above and foregoing
information
oris m edon is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application
Date(month,day,year)
Siynat rY a(owner's' ty 1 name) 05/09/2022
Full resident address of applicant(number and street, city, state,and ZIP code)
* 401 Swallowfield Drive,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)