HomeMy WebLinkAboutMortgage_Littlejohn STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
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t ,,. FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13/1045) Gibosn n 2017
Prescribed by Department of Local Government Finance
INSTRUCTIONS:
To be filed in person or by mail. Orr,rForm filed w .
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. 2,_].,
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is L!alliry Auditor
located on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor� ,Fo r
where the properly is located during the twelve(12)months before March 31 of each year the deduc flit/
See Applicant(owner or contract buyer-see restrictions s on reverse side) UNTYAVUIT.
Branden L. Littlejohn and Kylie M. Littlejohn R
Taxing District Key number/legal description R d number Paa um
Union 26-18-26-300-002.090-025 .-01(Q 3
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
224,500 1-SftSUO 210, (900 o 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
- a 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 Theater Dr., Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
Address of assignee(number an street,dy,state,and ZIP code)
Does applicant own property i any If yes,what county? Vat Taxing Disuict? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No current year? ❑Yes 0 N
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
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 aforementioned property on d t application is filed. Iryy, 1,It'r,11AA
Sian.' nets fullna Il' ( `J J�J`^"''V•1 _ Da(on(.daY.year), •
Ful resident address applican nginder and street,city,state,and ZIP co e)
2230 W 950 S, ort Branch, IN 47648
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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S10,000.