HomeMy WebLinkAboutMortgage_Michel (15) �� =;*F4. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
dd'-- "1. FOR DEDUCTION FROM ASSESSED VALUATION
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. . + State Form 43709(R13/10-15) ,
"="< Prescribed by Department of Local Government Finance
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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)
BRANDON C. MICHEL
Taxing District Key number/legal description Record number Page n mber
Union Township 26-19-21-100-000.712-025/Part NE NW 21-3-10 I X l°� 4(, Ti
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 equitab owner?
96,000.00 es No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom 0
If name on record is different than that of applicant,indicate below: Is the prop-rty in question:Annually Assessed
F ,$_.'i Property Annually Assessedfifo,
. ❑ 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) NOV 1 .5 2019
4405 Theater Drive, 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) GIBBON COUNTY AUDITOR
Does applicant own property in y If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? Yes o current year?
Ill ❑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:
20 920 20 20 20 20 20
Signature of County Au,, Co ty' Date(mon h day,y )
�Q'N u 1 ) N1
1/We certify under`e penalty of perju ove and foregoing informatid is true and correct and that the applicant i a resi nt of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name)
Date(month,day,year)
I resident address of applicant(number and street,city,state,and ZIP code)
1897 E. 750 S., Fort Branch, IN 47648
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)
Tho norollicc fnr noriun,ran inc.!!!tip imnricnnmanf on to twn and a half years and a fine not to AXCBBCI.i1O.000_