Loading...
HomeMy WebLinkAboutMortgage_Perry (4) C •�:q, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESSCountyTownshipYear FOR DEDUCTION FROM ASSESSED VALUATIONl '�'er P State Form 43709(R14/1-20) Gibson 2022 —--, Prescribed by Department of Local Government Finance File Mark INSTRUCTIONS:To be filed in person or by mail. Form filed with: Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. " 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. E County Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Benjamin W.Perry Taxing District Key number/legal description Record number �y� Page number COI 26-05-35-200-001.620-004 3bix a 40--. 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 e luitable owner? 277,272.00 Yes ❑ No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom ����\�✓✓✓✓J ����` If name on record is different than that of applicant,indicate below: Is th property in question:Annually Assessed eal Property ❑ Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller American Pacific Mortgage Corporation and/or Warehouse Lenders FIL EDAddress of mortgagee or contract seller(number and street,city,state,and ZIP code) 3000 Lava Ridge Court,Roseville,CA 95661 Name of assignee or other owner or holder of mortgage MAY 31 2022 Address of assignee(number and street,city.state,and ZIP code) , �V.h.CL-_' Does applicant own property i any If yes,what county? What Taxing District? Has this deducti bp,q ount of deduction on property for b other county in Indiana? El Yes No current year? Yes ❑No A person is not entitled to thi uction unless the person has a balance on the person's mortgage or c ract 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 is the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature of County Audit9r / County Date(month,day,year) /A-A0*76---' ''�rMMIl__ftr'r' 2-4// C.9;113 so- 1 67 3(/,d-,� I,We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and I owner/contract buyer of the aforementioned property on date application is filed. Si ner's full name) Date(month,day,yea. y May32,2022 ull resident address of a ant(number and street,city,state,and ZIP code) 4104 East 200 North,Princeton,IN 47670 Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,yearkt May��ii,,22�Lt',2022 Address of authorized person (number and street,city,state,and ZIP code) rho nanaltiae far neri,,n.ran inr,n,rie imprisonment up to two and a half years and a fine not to exceed$10,000.