HomeMy WebLinkAboutMortgage_Grangier .,E ?,,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
'' -.<� State Form 43709(R13/10-15) GIBSON Princeton 2020
L,,,s Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
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 IZI 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)
April/Stephen Grangier
Taxing District Key number/legal description Record number Page number
Princeton 26-12-07-103-001.183-028 2-0 20 otSO
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?
$172,812 ❑ 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
2] Real Property ❑ Annually Assessed
is Rik, Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller Fi ,
j
a
Evansville Teachers Federal Credit Union -�
Address of mortgagee or contract selle,f—h--^^-' -
Opt Crlr Steio MAR 2 2020
Name of assignee or other owner or h V r 12P-' •
Drawer NO....a.caY
Address of assignee(number and sire
[T� GIBSON COUNTY AUDI OR
Does applicant own property in any Card N O, 1
other county on property for
in Indiana? ❑Yes No 4 I 1 IQ current year? ❑❑ Yes ❑No
A person is not entitled to this ded 1 ' n's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any hoi. _ _,_._, ....__. ,,, „��uurrry 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
Sign Ye f County Auditor S,, 4k County / Date(month,day,year)
I/We certify under the penalty of perjury that thibove 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.
/c Signature i f ifnam J Date(month,day,year)
03/02/2020
Full r i ent address of ap is nt(number a d street,city,state,and ZIP code)
2 W Walnut, Princeton, IN 47670
erson 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.