HomeMy WebLinkAboutMortgage_Cox (21) , erio--0%,
Aei ___ i/ 20 2 3 CLa't.t-d oD U ��
""'• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1.
1'-t FOR DEDUCTION FROM ASSESSED VALUATION Gibson 0a:1 2022
N. ee State Form 43709(R14/1-20) �(- ,1 l
Prescribed by Department of Local Governmente Finance
}}}C�����^ File Mark
INSTRUCTIONS: To be filed in person or by mail. I S�'/ V d V — 1 j 2 13 Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the ded ctio is sought. El County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property County Recorder
is located on or before January 5 of the calendar year in which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jacob E. Cox
Keynumber/legal description I Record Page m r
Taxing District ^
�� �`f 26-12-17 400-000.187-027/PT W SE 17 2 10 1 AC
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is legaltheapplicant the
e sole?
assessment date,current year date of application
assessment date,current year$0.00 $78,075.00 El Yes 0 No
If no,what is his/her exact share of interest? I If owned with someone other than spouse,indicate with whom
Is the property in question:Annually Assessed
If name on record is different than that of applicant,indicate below: 0 Real Property 0 Annually Assessed
FILED Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Rocket Mortgage,LLC
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) DEC3 0 2022
1050 Woodward Avenue, Detroit, MI 48226
Name of assignee or other owner or holder of mortgage -,` '
Address of assignee(number and street,city,state,and ZIP code) t%f ran a.. /irf Lrk;714
What TaxingDistrict? GI tItANN YbA r�`+Te'�ted I If yes,state amount of deduction
Does applicantun own property in any If yes,what county?
on property for ❑Yes ❑ NO
other county El Yes ❑ NO current year?
in Indiana?
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 I 20 I 20 20 I 20 20 20
County Date(month,day,year)
Signature of ounty Aud'rto 2- I Gibson 1/54097
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. Date(month,day,year)
�igp/3ture(pwners lullname) ,7 I? 170Z -
/X` / 111
Full resi ent address of appl (number and street,city,state,and ZIP code)
1234 E 150 S, 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.