HomeMy WebLinkAboutMortgage_Hurt (4) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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C'.''',- FOR DEDUCTION FROM ASSESSED VALUATION
i\I' ''►!-�••,... /' State Form 43709(R13/10-15) (W-L�
;ems Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. F r sled 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. ❑ 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)
Wesley S. Hurt and Stacy M. Hurt, husband and wife
Taxing District Key number/legal description `Record number Page number
Patoka 26-12-05-400-000.205-027 2-02-0 1 0c1
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 daTlf 9 plication legal or equitable owner?
� 0U6 . DO 0 Yes ❑ No
If no,what is his I her exact share of interest? If owned with someon 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
0 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)
4401 Theater Dr., Evansville, IN 47715 _Ft s
Name of assignee or other owner or holdr•--'m"rt' na f / /�
Address of assignee(number and street, 14�/°,`/C�'' (�3- y a'
�r}R 2020
Does applicant own property in any If P S .� Has th' uested If yes,state amount of deduction
/!/ /r
other county on prop
in Indiana? EYes ❑✓ No Ggiltiw,git)SiaQQ WsAU lt,KOR
A person is not entitled to this deduc, 1 /� — I`, /) n's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home �/)(/ if (, recorder's office)that is the basis for the deduction.
'OR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County 'torPC)
County Date(mAhC4y,year)
.
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 afore entioned property on date application is filed.
Signature(/n; 's full ame) Date(month,day,year)
i M .i4 4- 02/28/2020
7011-residess of pplicant(number and street,city,state,and ZIP )
910 N CaTrithers Rd., 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.