HomeMy WebLinkAboutMortgage_Avery .0.•".4, , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1i FOR DEDUCTION FROM ASSESSED VALUATION //(nI/111 3�
• State Form 43709(R13/10-15) . r\)7vh Y 4 `A4-0-Oh
' , ,.•✓', Prescribed by Department of Local Government Financelb
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INSTRUCTIONS: File Mark
To be filed in person or by mail. Form fi with:
Filing Dates: 1) Real Property: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 is County Auditor
located on or before January 5 of the immediately succeeding calendar year. ITIZ6 ounty Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Avery, Andrew
Taxing District Key number/legal description Record number Page number
Princeton 26-12-07-204-001.398-028 pot LI(Q
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?
$171,535.00 0 Yes ❑ 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
0 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Rocket Mortgage, LLC ISAOA F ALE L.,)
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1050 Woodward Ave Detroit, MI 48226 OCTName of assignee or other owner or holder of mortgage 1 Z 4 / I -
Address of assignee(number and street,city,state,and ZIP code)
W r(5 ..tiva.x..e.,, ✓
�t� uuttTOR
Does applicant own property in a If yes,what county? hat Taxing District? Has this equestedi I If yes,state amount of deduction
other county on property or
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 contr 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 r .)S U VI Date(month,d o%ay,year) 21/
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I/We certify under the 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.
Sign ure(ow er's full name Date(month,day,year)
10/21/2022
Full e ent address of applicant(number and street,city,state,and Z/P code)
730 East State Street, 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.