HomeMy WebLinkAboutMortgage_Badger a/.x"9. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
L�a FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13/10-15)
•. '• Prescribed by Department of Local Government Finance ���
INSTRUCTIONS: "'QQQ File Mark
To be filed in person or by mail. OI Form fled with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the ded&%bg is sough
Must be filed or postmarked with the County Auditor or County Recorder of the count tied the ropert ❑ County Auditor
located on or before January 5 o/the immediately succeeding calendar year. Y cn'O ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must fiM_with th-� my Auditor oYth county
where the property is located during the twelve(12)months before Mar3fS 5 . -arth�n is sought.
See reverse side for additional instructions and qualifications. "N co,
Applicant(owner or contract buyer-see restrictions on reverse side) r
Sarah L Badger yAuDyr
Taxing District Key number/legal description Qkecord num Ppg m er
Patoka 26-12-17-101-000.187-028 aOl 1'
Assessed value of real propeny as of Mortgage/Contract indebtedness unpaid as of Mortgage/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?
$119,090.00 0 Yes 0 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
I] Real Property 0 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 47716-5129
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? Vat 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 El 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
•
Signature of County Auditor County Date(month,day year)
I/ 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
o - /contract buyer of the at emen. ed prop y on date application is filed.
.Signatu. n:rs/•'na -) Dt man' year)
x .,I el l i 1 [Q�eag
resident address of applicant(number an reet.city.state nd ZIP code)
917 S Jefferson St, Princeton, IN 47670
Person authorized by duly executed Power of Attomey or by IC 6-t_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.