HomeMy WebLinkAboutMortgage_Renck 11, 4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13/10-15) Gibson _Patoka 2020
'ieie,1,Prescribed by Department of Local Government Finance I W f
c".n File Mark
INSTRUCTIONS: ' 1Ck Form filed with:
To be filed in person or by mail.
Filing Dates:1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the 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)
Nolan W. Renck, Katie J. Renck
Taxing District Key number/legal description Record number Pane number
Patoka 1103 26-11-15-202-001.123-027 2b 2p �L)u
Assessed value of real property asbf 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?
___$5,600.00 193,431.00 ❑ Yes ❑ No
If no,what is his I 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: a property in question:Annually Assessed
Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
L D
4401 Theater Drive, Evansville, IN 47715 A
Name of assignee or other owner or holder of mortgage 1 3 ZMZO
FEB LL
Address of assignee(number and street,city,state,and ZIP code) -.
• &I) Jhb?IF:u�
Does applicant own property in any If yes,what county? What Taxing District? sAmos,Ie§4Leagt If yes,state amount of deduction
other county GI r drtroF
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 20 20 20 20 20
Signature of Cou ditor County 1 Date(month,99day,year)
1 0" (61)) cben 2- • - 22z.2—k)
I/We certify under the penalty of perjury that the above and foregoing information is ttuu and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Si ature(owner's full name) (/ r Date(month,day,year)
e 02/07/20
resi ent address of applicant(number and street,city,s te,and ZIP code)
2550 W Susan Dr, 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,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. 43587