HomeMy WebLinkAboutMortgage_Spells (2) ,,t STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
.4- FOR DEDUCTION FROM ASSESSED VALUATION
ni State Form 43709(R13/10-15) Gibson Patoka 2019
4 j re Prescribed by Department of Local Government Finance . Tua 1A
File Mark f
INSTRUCTIONS: Form filed with:
To be filed in person or by mail. tt--,,//
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought. y� County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the �a County Recorder
property is located on or before January 5 of the immediately succeeding calendar year.
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)
Jason L. Spells , Chandra N. Spells
Taxing District ^ —Key number/legal description Rem b Page num r
Patoka bt a s 26-05-32-100-000.363-027 ' 'U
Assessed value of real property as f Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the so
assessment date,current year assessment date,current year date of application legal oyequnable owner?
$173,100.00 131,000.00 es a No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom _ _
If name on record is different than that of applicant,indicate below: Ti th ropery in question:Annually Assessed
eal Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal FILED
Address of mortgageecontract or seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
MAY 2811119
Address of assignee(number and street,city,stare,and ZIP code)
sn�tl
Does applicant own property in an If yes,what county? What Taxing District? Has this deduct T /1c I5paJF(ate amount of dedumion
other county on prol(�$G�ON
in Indiana? ❑Yes NO current year? ❑Yes ❑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 j
20 20 zo zo
Signature of Coun uc-ror Countyests Date(mo✓` y, a rt_-
I/We certify under the pen y of perjury that the abo foregoing information is tddrrr nd that the applicant is re nt�off IIndiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signalllre(owneR lull name ("Le2sterhcia
Date(month,day,year)
�Y} 05/20/19
Full esident address of ap n (number and street,ci ,and ZIP co
556 E 200 N, Princeton, IN, 47670
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,cry,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.