HomeMy WebLinkAboutMortgage_Lopez t'ex-.""'o. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION 1J�� 0 r� � 2 Z ,
` State Form 43709(R13/10-15) G n
'4. V Prescribed by Department of Local Government Finance \]
File Mark
INSTRUCTIONS: Form filed with:
To be filed in person or by mail.
Filing Dates: 1) Real Property: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 D County Recorder
located on or before January 5 of the immediately succeeding calendar year.
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)
Lopez, Eric
Taxing DistrictKey lei/��Z2 5 llJ1O
number/legal description I Record number I Page number
Princeton 26-12-18-102-002.175-028Is
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of legalte applicant
pli as t the sole
er?
assessmenty
assessment date,current year date,currentear date of applicationEl Yes ❑ No
$161,313.00
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
Is th Fin question:Annually Assessed
If name on record is different than that of applicant,indicate below: e III777 Annually Assessed
� ile Home(IC 6-1.1-7)
Name of mortgagee or contract seller ,A
Home Point Financial Corporation ISAOA/ATIMA AOV I
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 4�O2l
2211 Old Earhaart Road Suite 250 Ann Arbor, MI 48105 Cill f
Name of assignee or other owner or holder of mortgage OV t
yw` r.
Address of assignee(number and street,city,state,and ZIP code) gVt)/r`aR-
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio en requested I If yes,state amount of deduction
I on property for CI No
othercounty _,_/ current year? Yes
in Indiana? El Yes KJ No
A person is not entitled tbthis deduction unless the person has a balance on the person's mortgage o o tract 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)t t is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20
I 20 I 20
I 20 I 20 I 20 I 20
I County I IL Date(month,day,year)
Signal i�ounty udito 2 ro /`
I/ e certify under the/ penalty erjury that the ab -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. I Date(month,day, )year
Signature(/owners full-name) 1 1,year) 22
Full resident address of applicant(number and street,city,state,and ZIP code)
906 South Robin Street, Princeton, IN 47670 I Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
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.