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HomeMy WebLinkAboutMortgage_Rice (2) .ME"`'ew STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear V." FOR DEDUCTION FROM ASSESSED VALUATION f. ..(�+ State Form 43709(R13/10-15) GIBSON PATOKA 2019 "\yam i Prescribed by Department of Local Government Finance �aie 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 Taxing District Key number/legal description Record number Page number PATOKA 26-05-28-300-001.650-027 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? $37,000 IZI 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 question:Annually Assessed ❑✓ Real Property ❑ 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) Name of assignee or other owner or holder of mortgage . 9 �T �j What Taxing District? Has this deduction been requested If yes,state amount of deduction Drawer No.� `QL 0 onrentyeyfor current year? ❑Yes ❑No las a balance on the person's mortgage or contract indebtedness that is recorded in the county it is recorded in the county recorder's office)that is the basis for the deduction. Card ®. c7=W COUNTY AUDITORS 26-0.c-2 2-300-vnl . 6)‹ --027 20 I 20 I 20 20 20 20 20 Signature of County Auditor County Date(month,day,year) GIBSON 12/26/2019 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 pro erty on date app' tion is filed. X._. Sign lure(owners full na Date(month,day,year) 12/26/2019 Full resident ad ss of applicant(number and street city,state,and ZIP code) 2839 SR 65, PATOKA, IN 47666 L Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 DC(`Gl, 2 ! 2p19 Date(month,day,year) Address of authorized person (number and street,city,state,and ZIP code) , , fl ',j "' pR The penalties for perjury can include imprisonment up to two and a half years and a fine not tto e, d(d'l'v,d 00. RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Name of applicant Name of mortgagee or contract seller TERRY/COLENE RICE EVANSVILLE TEACHERS FEDERAL CREDIT UNION Date filed(month,day,year) Amount of indebtedness Taxing District 12/26/2019 $37,000 PATOKA Key number/legal description 26-05-28-300-001.650-027 Signature of County Auditor/County Recorder County Date(month,day,year) GIBSON 12/26/2019