HomeMy WebLinkAboutMortgage_Linsday (2) ..T-ii STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
( X FOR DEDUCTION FROM ASSESSED VALUATION
� ,'/) state torn urea 1 i 2c) Gibson Princeton 2022
, Presc-bed by Department of Local Government Finance ____..
File Mark
INSTRUCTIONS To be bled in person or by mad Form teed with
Filing Date Form must be completed and dated in the calendar year/or which the deduction is sought. ® County Auditor
Must be!fled or postmarked with the County Auditor or County Recorder of the county where the property re
located on or before January 5 of the calendar year in which the property taxes are first due and payable 1 D County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-sea restrrctrons on reverse side)
Shannon& James Linsday Taxing District Key num
-
ber I legal desrxiption Record number Page number
Princeton 26-12-07-303-004.218-028 2022 768
Assessed value of real property as of T Mortgage l Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date.current year assessment dale,current year date of epp'icalion Legal or equitable owner?
$ 107,000 i LA Yes 0 No
If no,what is his 1 her exact share of interest? If owned with someone other than spouse,indicate with whom
It name on repord is different than that of applicant,Indicate below is the property in question.Annually Assessed
®Real Property 0 Annually Assessed
Mobde Home(IC 6-1.1-7)
Name of mortgagee or contract seder
Amarisafe
Pjt,
Address of mortgagee or contract seller(number and street.city state.and
Name of assignee or other owner or holder of mortgage //4 -40
Address of assignee(number and street.city slate.and 21V 9 202 Q�C� �l
Gip
-, Tpiyrip3 -1 Has tars deduction been requested If yes,state amount of deduction
Does county applicant own property in any It yes,what county? fibIf .!/`i- I cn property for
other county 0 Yes Na NT �y�!• i current year? Yes ]No
in Indiana? <✓ � � y
A person is not entitled to this deduction unless the person has a balance on e)ryq)ts mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity fine of credit that is recorded in the coun ecorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of,
20
20 20 11 I...._._20 20 20 20
cur J Date(month.day art
Signature of County Auditor ) � z
/l `� a Gibson - .'- ` -_
1 i We \ ► L V�J . ._ ___
i! ce under he enafty of perjury that the above and foregoing inform lion is true and correct and that the applicant is a resident of Indiana and
owner t contract buyer of the aforementioned property on date application is filed.
n Date(m-�-o7nth /ay.year)
Signature(ow rs 1 name? �) ! g' 'l a-
-Fu res,rent address of applcant(flambee-Mid streeti nN.state,and ZIP,
502 W Monroe, Princeton, IN 47670 ate(month,day,yea?
PerSan authorized by dory executed Power of Attorney or by IC e-1.1-12-0
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 line not to exceed$10,000. -
RECEIPT FOR FILING STATEMENT OF M•' E OR CONTRACT INDEBTEDNESS
Noma of applicant mortgagee or contract seller
Shannon& James Linsday _ -risafe
......� _. A l o d c (gaigi— . taxtng District
Date fi,ed(month,day.year • ? - --_- $1°Kea Princeton
Key number I lega descr ption 9 1
26- _ _
12-07-303-004.218-028 0-1- v j_. oats(month day,yeah
-_ i cfg f(AliA
igna:urC alry Auditor/Courty F+e der - NICR v G� Z
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