HomeMy WebLinkAboutMortgage_Pohl (3) i� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e'm FOR DEDUCTION FROM ASSESSED VALUATION
11:.ifr:41 State Form 43709(R13/10-15)
C '„ Prescribed by Department of Local Government Finance .
INSTRUCTIONS: File Mark
To be riled in person or by mail. Form filed with:
Firing Dates: I) Real Property:Must be completed and dated in the calendar year for which(he deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is 0 County Auditor .
located on or before January 5 of the Immediately succeeding calendar year. 0 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 rastdcdons on reverse side)
Pohl, Adam J. And Courtney L.
Taxing District Key number/legal description Record number Page number
26-18-19-200-000.006-025 -2-OV 3 21 - '
Assessed value of real property as of Mortgage 1 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?
$484,000.00 In 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 ques' . ally Assessed
❑✓ Real Prop . r Ivy Assessed
• e Home(IC 6-1.1-7)
Name of mortgagee or contract seller `A '-
Evansville Teachers Federal Credit Union qQ//� �(07►�J
Address of mortgagee or contract seller(number and street,city,slate,and ZIP code) \ ry t��\�
4401 Theater Drive, Evansville, IN 47715 Y PvC)l of
�Name of assignee or other owner or holder of mortgage 1 O\'(
a IxJ
Address of assignee(number and street,shy,stale.and ZIP code) N -4
•
as INGG
Does applicant own property Ina if yes,what county? What Taxing District? Has this deduction been requested owes.state amount of deduction
other county on property for
In Indiana? ❑Yes current year? ❑Yes 0 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:
•
�J(¢20yn� ������.� 20 �� �A0 20 20 20 20 20
Sig tore oli' n�--u t -U'V 1.T--+--P— County Date(month,day.Year)(
II We certify under the penally of perjury that e a and foregoing Information Is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application Is filed. '
SI nature(owner's tug am pal, r1 (, J- v A(� Det (month,DI i 1yooe�
Full resident addre applicant(number and street,city,state,and ZIP rode) why\^J
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number end street city,stele,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S 10,000.