HomeMy WebLinkAboutMortgage_Yates At,**Tn STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
_tail FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11 /6-09)
51 2014
Prescribed by Department of Local Government Finance File Mark
•416
INSTRUCTIONS:
To be filled in person or by mail. ' fi I�?
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is soug
Must be filed with the County Auditor or County Recorder of the county where the property is located ❑ County Auditor
on or before January 5 of the immediately succeeding calendar year. • 2 p County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the JAN 2 2 2014
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) GIBBON COUNTY AUDITOR
Patrick W Yates and Trivia J Yates
Taxing District Key number/legal description 26-18-07-101-000.245-022/207 North First Record number Page number
Street, Owensville, Indiana 476652 s/Q
26-18-07-101-000.245-022 jq— �1u
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1.current year date of application legal or equitable owner?
$91,200.00 I I 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
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street city,state and ZIP code)
4401 Theatre Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ Yes No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of: -
-20 20 20 20 - __ 20 20 __ _
Signature of County Auditor County Date(month,day,year)
I/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.
Si.-.: ure • er's full names _ _ Date(month, •ay,ye-r)
rat— — iii ��
((40
Ful-esident address oTpplicant(number and street,city,state,and ZIP code) S
207 North First Street, Owensville, IN 47665
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)