HomeMy WebLinkAboutMortgage_Gray (10) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4.T . FOR DEDUCTION FROM ASSESSED VALUATION
oi'.,��` 6' State Form 43709(R13/10-15) I Gibson Princeton 2020
"0 -, Prescribed by Department of Local Government Finance 1
File Mark
INSTRUCTIONS: 1 Form filed with:
To be filed in person or by mail. • s�
, i Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought. l;" County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the 0 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. I
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jared T. Gray ,Janice K. Gray ! I ,
Taxing District Key number/legal description Re rd nu 9e num
Princeton 26-12-07-104-002.946-028
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 I legal or equitable owner?
$367,100.00 155,200.00 I ;rles 0 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 roperty in question:Annually Assessed
al Property ❑Annually Assessed
I - _ I Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller I
11
Evansville Teachers Federal I '
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 1
' 4401 Theater Drive, Evansville, IN 47715 e MAR 0 2 2020
.Name of assignee or other owner or holder of mortgage
i
Address of assignee(number and street,city,state,and ZIP code). �Q
GIBSON COUNTY AUDITOR
1 - .
Does applicant own property in any 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 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: I
I
!
20 20 20 20 20 201_ 20
•
Signature of County Auditor 04I -(1\ 611!:
� County \' Date(month, y, ar)
l�'f 1 3 2 nC�^'^(iI/We certify under the penalty o .erjury that theforegoing information i t ue and correct and that the applicant is a sid nt of Indiana and
owner/contract buyer of the aforementioned property on date application is filed. 1
•
Signature(owner's full name)��`— Date(month,day,year)
`6��. �� 1 02/25/20
Full resident address of applicant(number and street,city, • and ZIP code)
-N Prince Street, 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. 43854