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HomeMy WebLinkAboutMortgage_Allen (19) E ^•*•4 STATEMENT OF MnRT(AGE OR CONTRACT INDEBTEDNESS County Township Year FORDEDUCTIO �yState Form 43709(R14/1- /! Oxi Gibson Patoka Township 2022 Prescribed by Departmr �e�V File Mark INSTRUCTIONS: To be filed in pars Form filed with: FilingDate: Form must be oomph l'3 53(Q ion is sought.g County Auditor Must be filed or postr e county where the property is located on or before, rs 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) -Myron I Allen Taxing District Key number/legal description Record number Page number Patoka Tonwship 26-12-05-200-004.284-027 2021 3536 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 equitable owner? $104,000 DYes ❑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 the property in question:Annually Assessed PI Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Spring Valley Bank Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 406 Name of assignee or other owner or holder of mortgage - r 202? ` G/eSO 2 t� Address of assignee(number and street,city,state,and ZIP code) (/N _ll�� T y e2,.ftr� Does applicant own property in any If yes,what county? What Taxing District? Has thiseeduPitth been requested If yes,state amount of deduction other county on property for I� in Indiana? ❑ Yes ❑Yes ©No current year? No A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract 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 is the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature of County Auditor n I County Date month,day,year) ._fir. Q a- . l f_ �u a �r--� / C7"t �j ®,.-,.. - ( -Z 2_ I/We ertify under the penalty of perjury that the above and foregddiing 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. Signats full name) Date(month,day,year) 08/01/2022 )ull resident addre of applicant(number and street,city,state,and ZIP code) 1487 N Carithers 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) ',-ess of authorized person (number and street,city,state,and ZIP code)