HomeMy WebLinkAboutMortgage_Hostettler 0 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Colin Township Year
lit FOR DEDUCTION FROM ASSESSED VALUATION
.11 State Form 43709(R12/6-14)
IPrescribed by Department of Local Government Finance T
INSTRUCTIONS: Y IL ,. 9. File Mark
To be filed in person or by mail. Form 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 coubbikvh'e4hg perty is County 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 of the county
where the property is located during the twelve(12)months before March 31 of eac ar the d du a+ssoughl.
See reverse side for additional instructions and qualifications.
Applicant(owner ar contract buyer-see restrictions on reverse side) GIBSON COUNTY AUDITOR
Matthew D. Hostettler
Taxis �sqqi Key number/legal description Record number Page number
t C{� 26-18-24-204-000.194-026 0-o ( � 3l O%S
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?
/O1� 8OQ ID Yes ID 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
❑ Real Property ❑ Annually Accessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union
Address of mortgagee or contract sever(number and street,city,state,and ZIP code)
440 i Thea-er DrWUei Evonsvt Ike ztl 47"I 15
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 I If yes,what county? What Taxing District? �' eduction
other county ❑Yes ❑No
in Indiana?
A person is not entitled to this deduction unless the person has a balance on the per. 1 .....•••••• " he county
recorder's office(including any home equity line of credit that is recorded in the count Dr a\\'Cl \O
COUNTY AUDI ///�1 //�/�
Deduction approved in the amount of: 1 iJ, •••' ''•'•Card NO. ••'
20 1 20 20 20 I zu 20 20
r
Signature of Coun•, •i;I ,T q County I ; Data(month,ddy,ygar).x ! ,7
I/ 'e certify under the penalty of perjury that th above vvoi information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property o e lei lion is filed.
,...,_,Signature owner full name) / ...Dorm(month,day,year)
.0. Y� / 07 —/Z -20/7
Full r (dent address of applicant(number a sheer •a• and ZIP code) __--iv tf7(ovp
/Obd S Ta-/h'. r+8(ancC_ o
Person authorized by duty executed Power of//Homey or by IC 6-1.1-12-0.7 / I Date(month,day,year)
Address of authorized person (number and sheen city state.and ZIP code)
The nonabinc(nanun■ran inrh Ida imnrisnnmanl nn In ton and a half veace and a fine not In arraal S10.00M. _ - -