HomeMy WebLinkAboutMortgage_Raney (2) ^:t.4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e4. 1. FOR DEDUCTION FROM ASSESSED VALUATION
7711' Gibson Ow 2022
State Form 43709(R 14/1-20) RECEIVED'\-,... 1'�, Prescribed by Department of Local Government Finance
INSTRUCTIONS:To be filed inperson ormail. " (� ( OCT 1 1 2022 File Mark
by 1��\1 1\� �3�/t.Gam.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property County Auditor
is located on or before January 5 of the calendar year in which the property taxes 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)
JAMIE ANN RANEY
Taxing District Key number/legal description Record number Pageag number
�
26-12-17-103-004.246-028 -D Z J Z- J c(2__
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applica the sole
assessment date,current year assessment date,current year date of application legal or equ le owner?
137,362.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,' dicate with whom
If name on record is different than that of applicant,indicate belowjT T E D Is t property in question:Annually Assessed
11 ■�_-A Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller OCT 1 4 2022
EQUITY PRIME MORTGAGE,LLC
Address of mortgagee or contract seller(number and street,city,state.and ZIP code) t �_"
PO Box 1194,Springfield,OH 45501-1194 tf)q 4,,,,f a. ,YY rka
Name of assignee or other owner or holder of mortgage GIBSON COUNTY AUDI(OF
Address of assignee(number and treet,city,state,and ZIP code)
Does applicant own property i ny If yes,what county? What Taxing District? Has this deductio een requ d If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No current year? Yes No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or o ract ind tedness 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 1 Date(mo h,da year)
Nv-r-1 R
30c)
I/We certify under the penalty of perjury that the above and foregoing information is true nd correct and that the applicant i a res ent of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Si nature(owner's full name) Date(month,day,year)
Pr ^
�j� e oa ` �]i June 16,2022
f a u I sident address of (number and street,city,state,and ZIP code)
910 E Ohio Street,Princeton,IN 47670-3065
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
June 16,2022
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.
IRECEIPT FOR FILING STATE �I`�-�'Ir F■p�/R, - - CONTRACT INDEBTEDNESS (l
Name of applicant N �- •f 2 .ee pr-e�ntract seller l \ l�`��
ire �I/
JAMIE ANN RANEY '�• �Yn�
Date filed(month,day,year) Amount of indebte�{' ss Taxin Disj%(ict C
1O-1�--142 2-
Key ���3�13�.dO22 -{ Ill
number/legal description _,.
# 26-12-17-103-004.246-028 ��22 —3 5�2 "' C
Signature of County Auditor/County RecMr `��� GIBSON coU A Q{ D`U-1.,\---. "4°2:1