HomeMy WebLinkAboutMortgage_Dyson (2) . R,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
yj ZE) FOR DEDUCTION FROM ASSESSED VALUATION
71� if) State Form 43709(R11 6-09) Gibson .r.inte(n 2022- / Prescribed by Department of Local Government Finance y� T�S�
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 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. El 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 estricti ns on reversQside)
* Brian Dyson and Courtney-0ysen '1''Q-/'1— U_Lt$Ob'i
Taxing District O�� Key number/legal desc,Ipiion {�O) ->�-400- Ott-I}6- �Z- Record r�umpeF3, Page number
`PT N SE 31 1 10.9061 AC C-1 " •a4 d!�
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 *$207,920.00 CI Yes El 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 th roperty in question: Annually Assessed
�% ierty CI Annually Assessed
/�+Jy`,✓EMobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
• Bank of England
Address of mortgagee or contract seller(number and street,city, state, and ZIP code) JUN 1::)
' PO Box 3490,Little Rock,AR 72203 �j ,
Name of assignee or other owner or holder of mortgage Q. /L_ _ 2
'crSING VHTY r i ,.
Address of assignee(number and street, city,state, and ZIP code) �rl�Qy _�,Jb——
Does applicant own property in any other In yes,what county? What Taxing District? Has thisid i _'1K een e uested on property
county in Indiana? for current year.
❑ Yes 15eNo Yes ❑ No
COUNTY • -
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Count Date(month,day,year)
I/We Certify under the penalty of perjury that the above and f regoi formation 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.
S natur 'ggr's fuI ame) / Date(month, day,year)
ei-c�4- S( 05/20/2022
Full resiidendent address of applicant(number and street, city,state,and ZIP code)
" 1872 N.Old Petersburg Road,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)