HomeMy WebLinkAboutMortgage_Jackson (4) <anp, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
,s._~ 1 FOR DEDUCTION FROM ASSESSED VALUATION FILED
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State ilbe 4 709(R1 Department 4) g� n L Ej D
\‘','..• ✓` Prescribed by Department of Local Government Finance J19� 1R1 Lqt '�
File Mark
INSTRUCTIONS:
To be filed in person or by mail. J UN 8 209.filed 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. • i ,l"� aunty Recorder
-- 2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor oft 'talc', .s it r+rll n
where the property is located during the twelve(12)months before March 31 of each year theC*f S1 gp 4 1•.e r' Y AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Brenda L. Jackson
Taxing District P Key number/legal description Rico ouT Pag b.2.
Ft. Branch Township 26-18-24-204-000.649-026 / l/`�\1—
II 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?
55500.00 43000.00 p Yes ❑ No
e If no,what is his I 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
❑ 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)
4405 Theater Drive, P.O. Box 5129, 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 If yes,what county? What Taxing District? Has this deduction been requested 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 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 20 20 20 20 20 20
Sign tore of County Auditor ,- County Date(month,day,year)
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.
nature(owners full name),, '/ Date(month,day,year)
ceittodit, d'Full resident address of��PP4cl aant(number and street,city,state,and ZIP code)
1009 S. Center Street, Ft. Branch, IN 47648
Person authorized by duly executed Power of Attomey 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.