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HomeMy WebLinkAboutMortgage_DeFelice r� 4,v,STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year FOR DEDUCTION FROM ASSESSED VALUATION ©ZO `�2Z R� State Form 43709(R14/1-20) Gibson DD • Prescribed by Department of Local Government Finance RECEIVED _1 File Mark INSTRUCTIONS_ To be filed in person or by mail. �lll WUr► l I' Form filed with: year2 5 2022 gi County Auditor Filing Date: Form must be completed and dated in the calendar for ich the uction is so�jh� Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is County Recorder located on or before January 5 of the calendar year in which the property taxes are first due and payable. See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Mario DeFelice and Emily DeFelice Taxing District Key number/legal description Record number Page number Princeton 26-12-08-203-002.001-028 '?-q2Z 2l3 86 Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is legal the eplua blt the owner? sole assessment date,current year assessment date,current year date of application n q $155 ,000 .00 es ❑No If no.what is his/her exact share of interest? Fne�.wother than spouse,indicate with whom If name on record is different than that of applicant,indicate below: IL/ .: Is the property in question:Annually Assessed Real Property D Annually Mobile H e Home(IC 6-1.1-7) Name of mortgagee or contract seller JUN 2 B 2022 Fifth Third Bank, National Association Address of mortgagee or contract seller(number and street,city,stet ZIP d �, UD;TOR 5050 Kingsley Drive MD 1MOC BS�cfit#i�Ta it OH 45263 Name of assignee or other owner or holder of mortgage Address of assignee(number and street.city,state.and ZIP code) Does applicant own property in any If yes,what county? What Taxing District? Has this deducti be requested If yes,state amount of deduction other county on property for Yes No in Indiana? 0 Yes Ij No current year? A person is not entitled to this deduction unless the person has a balance on the person's mortgage or nt 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 s the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 / 20 20 20 20 20 • �r� Signature of County Auditor "" / /•�\ County 1 Date(month,day.year) tils I/We certify under the penalty of perjury that the above and foregoing information is 4e and correct and that the applicant is a resident of Indiana and owner I contract buyer of the aforementioned property%on date application is filed. v- Siggnajure(owner's full name) Date nth.day.year) cx5(month. /2 ull resident address of applicant(number and street,city state,and ZIP code) 501 Johnson Ave. , 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) The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000. RECEIPT FOR FILING STATEMENT OF MORTGAGE, OR CONTRACT INDEBTEDNESS Name of applicant �a i ` " ,�' 'cra`)�anrk, National Association Mario DeFelice and Emily DeFelice 11.-JJ mp �f irU}e�t�d=e,�� Taxing District Date filed(month. ay year)p�p 11 U U U V 28 • 20 '2.2 r JUN 20�2 Fri nCmtr�n Key number/legal description /�22 22 g C 26-12-08-203-002.001-028si Date<montn.day,yea0 yr fll Signature of County Auditor/County Recorder /\^� It`^" ""'n�TY AUDITOR N fCT1 Mv0 ►t l J GIBBON 6.2$ •2 2