HomeMy WebLinkAboutMortgage_Bezy (2) < n n STATEMENT OF MORTGAGE OR CONTRACT. IP+D B p ESS CountyTownshipYear
�: ;.. a FOR DEDUCTION FROM ASSESSED VALUATICW'
" _ k)� State Form 43709(R13/10-15) MAY 0 1 2020 Gibson `�� 2020
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'� =-�`' Prescribed by Department of Local Government Finance
�016
INSTRUCTIONS: ' � •
File Mark
To be filed in person or by mail. C � �y 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)
TROY J.BEZY and AMY N.BEZY
Taxing District Key number/legal description Record number Pa a number
vA!J So—) 26-23-02-200-002.003-024 7,02,0 11-3 1
Assessed value of real property as of Mortgage i 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 eq stable owner?
308,000.00 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: the property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union,its successors and/or assigns as their respective inte t-qi near i ..,
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) R
4405 Theater Drive,Evansville,IN 47715 a .
Name of assignee or other owner or holder of mortgage
MAY 01202d
Address of assignee(number and street,city,state,and ZIP code)
Does applicant
nt own property in any If yes,what county? What Taxing District? oHas n pr � tli 9 �u�f es,state amount of deduction
other countyITOR
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
Signature of County Auditor Cou \ Date(month,day,year)
I/We certify under the penalty of perjury that the abo oregoing information i rue and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
Signat (owner's full n e) Date(month,day,year)
April 20,2020
Full resi t ad ress of p nt(number and reef,cif d ZIP code)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
April 20,2020
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.
RECEIPT FOR FILING S , ,, •F 'y:" Fi' `i OR CONTRACT INDEBTEDNESS
Name of applicant tm. a 1 it ortgagee or contract seller
TROY J.BEZY and AMY N.BEZY 1' ."' t.;!, ' IC v\
Date filed(month,day,year) Amount'of'ind'ebtedhess ' Taxing Distri \
S^- \- 2 olo ;MAY 03 ,=eked.;_ , ; NN-
Key number I legal description
26-23-02-200-002.003-024 n� '._ ' 22020 — �� -
Signature of County Audito /Count a or r Date(month,dayear
c) SC'1r OIBSON COUPIT" gIbITOR year)
Vandenburgh • \-2,0ZD•