HomeMy WebLinkAboutMortgage_Emery (2) 01-n?-.v. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship
" •w FOR DEDUCTION FROM ASSESSED VALUATION Year
°i ' ,tr>! State Form 43709(R13/10-15) Gibson «/W
i %.4 Prescribed by Department of Local Government Finance �(/1�-/�/�J
INSTRUCTIONS:
Drawer ltTO.. 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 ye 2
Must be filed or postmarked with the County Auditor or County I Card NO, - J� ,is ■❑ County Auditor
located on or before January 5 of the immediately succeeding c • ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:, unty
where the property is located during the twelve(12)months befd sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Ross &Jenny Emery
Taxing District Key number/legal description Recordnumber Page nAnbarr
Johnson 26-23-11-200-002.187-024 V to jj
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?
$280,000 ❑■ 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) AZ
s"
'.46.....26 .
Name of assignee or other owner or holder of mortgage to
�Ob
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-6,04 ,
ege,
Address of assignee(number and street,city,state,and ZIP code) illCr,
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction beers r�• -sted `'if yes,state amount of deduction
other county on property for
in Indiana? Yes No current year? ❑I
El Yes C!" e
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebte•hiss 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 County Auditor County Date(month,day,year)
J -1/4_1,0-.-4,-As,3 Gibson 02/27/2020
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 property on date application is filed.
Signature(owner's full name) Date(month,day,year)
i C__—_C 02/27/2020
Full resident address of applicant(number and street,city,state,and ZIP code)
11350 S Brookview Ct, Haubstadt
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.
ter.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES
Name of applicant Name of mortgagee or contract seller
Ross &Jenny Emery Evansville Teachers F c,ra Cr Voh
Date filed(month,day,year) Amount of indebtedness i • tri,"
02/27/19 $280,000 J nson Q.ft tila
Key number/legal descriptionAi '
26-23-11-200-002.187-024 0 t �nek�
Signature of County Auditor/County Recorder County D to(mo Mead,
i L^3 Gibson 62 si ,-
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