HomeMy WebLinkAboutMortgage_Lantrip •
f -"o STATEMENT OF MORTGAGE OR CONT I.. • . =T County Township Year
AA"_ ': FOR DEDUCTION FROM ASSESSED VALU •I.
a ' State Form 43709(R12/6-14) - �.
',-,�_-d• Prescribed by Department of Local Government Finance q
INSTRUCTIONS: JUN 2 4 2016 File Mark
To be filed in person or by mail. Form fled with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year fo which the dedu Lion" ught.
Must be filed or postmarked with the County Auditor or County Re er df where the property is purity Auditor
located on or before January 5 of the immediately succeeding cafe ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Proptili3550433 Okt iltStAIPATi6kRr 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)
Lantrip, Jennifer L.
Taxing District Key number I legal description Record number Pa a number
Princeton 26-12-07-403-001.121-028�Iliams 4 Pt 9•'�j ; J5if
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 equi,ble owner?
90,800 72,500 124,000 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 perty in question:Annually Assessed
• Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
-
Name of mortgagee or contract seller -
Evansville Teachers Federe L AI T/117°
Address of mortgagee or contract seller(numbers 7�ur n
4405 Theatre Dr., P.O. Box
Name of assignee or other owner or holder of mor I W-, 51 a
Address of assignee(number and street.city.stall
Does applicant own property in a If yes,what - ._.._ n ....,.,,, una <vucum ueen requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No I 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 a-edit 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 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 aforem ntioned property on date application is filed.
Sig 'tun (owner's full : e) Date(month,day,year)
. .. C CO — i(D - 1
Full res tent addres-of apt icant(number and sb� city,tstate,and ZIP code) ff II
rJ (.t) . ' 1 nc &-. 1-02-- - s�.h D +7(0'Ct.
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 r Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code)
_Pin nnnntU e 1r_naA',n,ran include imprisonment uo to two and a half years and a fine not to exceed 510,000. >v