HomeMy WebLinkAboutMortgage_Dawson (2) 4o-kr-ArP STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
ov:.,, ,a. County Township Year
ai► - AA FOR DEDUCTION FROM ASSESSED VALUATION
"\�,�r J. State Form 43709(R13/10-15) I j.,
,.Fy a 6�' Prescribed by Department of Local Government Finance s _
'INSTRUCTIONS: File Mark
To be filed in person or by mail. MAR 3 2020 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. i
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the.Cou i'a/r tr''1'county ❑ County Recorder
where the property is located during the twelve(12)months before March 31 otkistimir(bolgsagclforlaEliTOP
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Bradley A. Dawson and Heather Dawson, husband and wife
Taxing District Key number/legal description Record number Page number
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?
/51), 2O? E 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
El Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller n-
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Dr., Evansville, IN 47715I --
Drawer NO.....cUa0
Name of assignee or other owner or holder of mortgage •• .............
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Address of assignee(number and street,city,state,and ZIP code) Card NO. ........ C O f�
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requestea ,,,__, V fiction
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:
20 20 20 20 20 20 20
Signatu a of County Auditor County Date(month,day,year)
I/We certify under the penalty of perjury tha the a e 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.
Sign ure(own is full nam ) Date(month,day,year)
etc y ��� / J 02/25/2020
Full resident address of applicant(number and street,city,state,and ZIP cooej
4397 S550 E, 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)
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