HomeMy WebLinkAboutMortgage_DeHosse (2) tie'4.re STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
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1 c7 = FOR DEDUCTION FROM ASSESSED VALUATION -
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gc; i'.;.,4y State Form 43709(R13/10-15)
'• "' ' Prescribed by Department of Local Government Finance
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INSTRUCTIONS: 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 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)
Stacy L. DeHosse
Taxing District Key number I legal description Re d number Page num r
Princeton 26-12-18-302-000.188-028 /,02C tOd
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 p�ap cat legal or equitable owner?
(�I D 0 Yes IDNo
If no,what is his/her exact share of interest? If owned with someone otrier 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 Re-I -roperty ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller f
Evansville Teachers Federal Credit Union —
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Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 0
4401 Theater Dr., Evansville, IN 47715ik. ti0ti
Name of assignee or other owner or holder of mortgage 0
Address of assignee(number and street, _ ; /1 • �� PVO\‘ �O
Does applicant own property in any If s deduction requested If yes,state amount of deduction
other county ,\ %/�`l lefty for
in Indiana? El Yes ❑✓ No U r (J(J year?G Yes ❑No
A person is not entitled to this deduc rage or contract indebtedness that is recorded in the county
recorder's office(including any home 's office)that is the basis for the deduction.
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signs re of County Auditor County Date(month,day,year)
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I/We certify under the penalty of perjury thaIIthe ab and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contrac yer of the aforementioned prope y on date application is filed.
Signature(owner's f e Date(month,day,year)
02/28/2020
Full resident ad ss of applicant(n m rand street city,state,and ZIP code)
1709 S Main St., 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.