HomeMy WebLinkAboutMortgage_Rehl j-B7f> STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
..;4: FOR DEDUCTION FROM ASSESSED VALUATION (((111 Gibson O2� �22
tft r� State Form 43709(R14/1-20) 1/
Prescribed by Department of Local Govern ent Finance UVel
t ,- 1 1 6/ I2
File Mark
INSTRUCT/ONS: To be filed ir1 person or by mail. ,T�j �j� �\ Form filed with:
FilingDate: Form must be completed and dated in the calenaryear Qi w ch the deduction is s ught. m County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is
located on or before January 5 of the calendar year in which the property taxes are first due and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Triston Rehl
Taxing District-----, Key number/legal description Record number Page nu rr
Patoka Imo)S 26-12-15-200-003.590-027 ? Z 7.5(1
Assessed value of real progeny as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness u pF ai3as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$168,785.00 0 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: F LET Is the property in question:Annually Assessed
LED ®Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Freedom Mortgage Corporation dba Freedom Home rv3p1!t J9 gyaoration
Address of mortgagee or contract seller(number and street.city,state,and ZIP code)
951 Yamato Road, Suite 175, Boca Raton, FL 33 co,21 1 ca
Name of assignee or other owner or holder of mortgage GIBBON COUNTY AUDITOF,
Address of assignee(number and street.city,slate.and ZIP code)
Does applicant own properly in any If yes,what county? What Taxing District? Has this deduction n requested If yes,state amount of deduction
other county on property for Yes 0 No
in Indiana? ❑Yes 0 No current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ont ct 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)that' the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 a200 20 k 20 20 20
Signature of County Auditory) County ^ ` Date,( ofrth. ay,year)
I/We certify under the penalty of perjury that the above and foregoing information is-ttue and correct and that the applican is a esident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name) Date(month,day,year) .
"-ti ' W.0 J 05/31/2022
Full resident address of applicant(number and street,city,state,and ZIP code)
3120 E Top Hat Rd, 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Triston Rehl Freedom Mortgage Corporation dba Freedom Home Mortgage Corporation
Date filed(month,day.yea Amount of indebtedness Taxing District
G'Ic I22 $168 5 ��C� Patoka
Key number/legal descri tion ` e -- 0 �'2S C.26-12-15-200-003.590-027 JUN 0 9 2022 !ice'
Signature of County Auditor/County Recorder -�-� County Date(month.day,year)
cif)3 G'son 6'°\- 22—
GIBSON COUNTY AuLiitu.,