HomeMy WebLinkAboutMortgage_Banister z STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
e4 FOR DEDUCTION FROM ASSESSED VALUATION
• S
y tate Form 43709(R12/6-14)) :
¢ Prescribed by Department of Local Government Finance
INSTRUCTIONS: e k r ;9)
To be filed in person or by mail. Fi Rrini filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. ' ��nty aunra'�l r
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is 6
located on or before January 5 of the immediately succeeding calendar year. I County Recorder
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 sc�ht i'/rr r��i.y��'
See reverse side for additional instructions and qualifications. ts SON COI IN
Applicant(owner or contract buyer-see resfictians on reverse side) TY R UOl rOR
Banister, Ian
Taxing District Key number/legal description I Record number I Page number
Ft. Branch 26-18-24-204-000-881.026/Brenton Add 4 L "/67 3 a/ 7
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 equity owneR
62,400 84,000 79,000 es ❑ 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 th perry 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 Dr., P.O. Box 5129 Evansville, IN 47716 --- -- -.
Name of assignee or other owner or holder of mortgage
Drawer t —
Address of assignee(number and street.city state,and ZIP code) 1�0
Does applicant own property in If yes,what county? What Taxing District? Has thi ca.. . O. .. •. •• •••• —`
other county on pro UU )�'
in Indiana? ❑Yes No curren : _
A person is not entitled to this deduction unless the person has a balance on the person's moo - j �"1„[J_/O O� y
recorder's office(including any home equity line of credit that is recorded in the county recordc. (0 �l _
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 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 properly on date application is filed.
Signature owner's fu ame).....____ Date(month,day,year)
DF-2,- 1 (e
Full resident address of applicant(number and street,city state,and ZIP code)
724 5 Sf<,nrncr.-. 4- .Pr :el ce1- t 97(970
Person authorized by duty 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)
The penalties for perjury can include imprisonment up to Iwo and a half years and a fine not to exceed S 10,000.