HomeMy WebLinkAboutMortgage_Dunning a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
_aa-'` FOR DEDUCTION FROM ASSESSED VALUATION
\,: '�t� State Form 43709(R13/10-15) I S Pao
\ % Prescribed by Department of Local Government Finance MCI P cv- 5- I4-I 1
INSTRUCTIONS: 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 county where the property 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 each year the deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Stephanie A. Dunning
Taxing District Key number/legal description Record umber Page number
Union Township 26-19-18-302-000.854-026 I$- 'sag
Assessed value of real property 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?
$132,050.00 ❑ Yes ❑ No
If no•what is his/her exact share of interest? It 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' 'nnually Assessed
ID Real Pro 1 ally Assessed
t t e Home(IC 6-1.1-7)
Name of mortgagee or contract seller I� q J •,
Evansville Teachers Federal Credit Union JY✓
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) ' 1.0
4405 Theater Drive P.O Box 5129 Evansville, IN 47716-5129 4I),( 8 L
Name of assignee or other owner or holder of mortgage
• p�S OR
Address of assignee(number and street,dry,state,and ZIP code) C.
N-��( PV
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been req tl' 1It y yes,state amount of deduction
other county on property for
in Indiana? ❑Yes ❑No current year? ❑Yes CI 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/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 date application is filed.
S natu owner's full na a Date(month,day,ye l)
nGt,Fn �/ � �
Full rest t t a dress of applicant(nu er Z and street.city.s;at .and ZIP code), , IN 47648 804 E Tretter Park Dr
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$10,000.