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HomeMy WebLinkAboutMortgage_Payne (3) <" " STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year sl ,� :,i FOR DEDUCTION FROM ASSESSED VALUATION Gibson 0 28 2022 �N.. "/� State Form 43709(R14/1-20) `� Prescribed by Department of Local Government Finance File Mark INSTRUCTIONS: To be filed in person or by mail. Form filed with: El 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. 0 County Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Zachary Payne Taxing District Key number/legal description Record number age number Princeton 26-12-07-303-002.693-028/PRINCE PLACE 2 PT/3 -2 0 2-2._ . - . 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 uitable owner? $0.00 $199,485.00 Yes 0 No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom VV\\ If name on record is different than that of applicant,indicate below: e property in question:Annually Assessed Real Property 0 Annually Assessed D Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Mortgage Research Center LLC dba Veterans United Home Loans Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 1400 Veterans United Dr.,Columbia, MO 65203 OCT 1 2022 Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city,state,and ZIP code) Vhc /J Lll.G1(�1'w `TOR Does applicant own property in any If yes,what county? What Taxing District? Has this 6EIigt?. ,..en r8queste AUD I If yes,state amount of deduction other county ❑Yes ❑ No on property for fa. Yes 0 No in Indiana? current year? A person is not entitled to this deduction unless the person has a balance on the person's mortgage or.ontr-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 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 , County Date(month,day,year) /y j_� A)o���= 7/ Gibson l®Z/,j/.v.)--)-- 1/We certify under penalty of perjury that the above and foregoing information 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. / clay rr11 ��Si/�9'pature(owner's I me Dvl, D °th/f/�yN full resident a app nt ber a street,city,stets,and ZIP code) "IL V�L/ vl 507 W. onro .;"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) The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.