HomeMy WebLinkAboutMortgage_Bradshaw (2) �►r�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
7a/°.'_ FOR DEDUCTION FROM ASSESSED VALUATION
t"�� State Form 43709(R13/10-15) Gibson 2019
Prescribed by Department of Local Government Finance
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 0 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)
ChristopherL./Kyleigh B. Bradshaw 812-779-4656
Taxing District Key number/legal description Record numb Page number
Montgomery 26-11-31-400-004-608-021 ZO' • 2026
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?
$288,000 ❑i Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
I If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
■❑ Real Property LI Annually Assessed
ome(IC 6-1.1-7)
Name of mortgagee or contract seller ,.
Evansville Teacher's Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) q
Name of assignee or other owner or holder of mortgage �PNt "0�0
\VtN
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own roe anyIfyes,what county? What TaxingDistrict? Has this deduction been requested I , t®2'amo mount of deduction
PP property rtY in tY� q 6
other county on property for
in Indiana? ❑Yes El No current year? ❑Yes ❑I®b—
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 County Date(month,day,year)
k5IU I-ts'>n-L1124i- Gibson 05/19/2020
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 aforementioned property on date application is filed.
Signature(owner's f me) Date(month,day,year)
05/19/2020
Full res ent address of applicant(number and stree, ity,state,and ZIP code)
5864 W Old Princeton Rd., Owensville, In 47665
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.
P
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE "' *'
Name of applicant Name of mortgagee or contract seller �:l
ChristoP Y 9 herL./K lei h B. Bradshaw Evansville Teacher's Federa et on
Date filed(month,day,year) Amount of indebtedness Taxing Distr' 7.0
05/19/2020 $288,000 Montgomery M(s`( 9
Key number/legal description
oo0di Signature of CountyAuditorCounty
/ Recorder County Date(m t �( 1\' SOR
,e1, Gibson 05/1g a P
GAB ILO
n 0t' ill'C�