HomeMy WebLinkAboutMortgage_Alexander (2) ��r•. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM — -- —-
State Form 43709(R14/1-20)
Prescribed by Department of Local
INSTRUCTIONS: To be filed in person or by ma Drawer
NO.•..aGa0 File Mark
••.• Form fled with:
Filing Date: Form must be completed and da • County Auditor
Must be tiled or postmarked wilt, �a� � �10 g •U • r the property is Coun
located on or before January 5 c ••• .. and payable. ❑ ty Recorder
See reverse side for additional instructions and qualifications. .
Applicant(owner or contract buyer-see restrictions on reverse side)
Jacy L&Janet R.Alexander
Key number/legal description Recoj n�u,mber Page number
26-19-19-103-001.204-026 U�(J� l5'
As ssed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sale
assessment date,current year assessment date,current'year date of application legal or equitable owner?
$107,000.00 ZYes ❑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
®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)
Name of assignee or other owner or holder of mortgage
Address of-assignee(number and street,city,state,and ZIP code)
Does applicant own property In any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property far -
in Indiana? Dyes ®No currentyear7 0Ye5 ❑No
A person is not entitled to this deduction unless the person has a balance on the persons 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 Coun r County Date(month,¢ay,36vier)��
I, certify under the penalty of perjury that the a,' y going information is true and correct and that the applicant Is a resident of Indiana and
owner!contract buyer of the aforementioned property on(late application is filed.
Signature es • m Date(mon h,+
Full nt address of appt' (number and street city,state,and ZIP code)
4 S.Andee ane, Ft. Branch, IN 47648
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.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Jacy L&Janet R Alexander Evansville Teachers Federal Credit Union
Date file (month,day,year) Amount of indebtedness Taxing District
a(,-c D $107,000.00 Fort Branch
Key number/legal description
26-19- 103-001.204-0 �•
• Signature o Co ,ty Aud"or/County R- // County Date(ma ,day,year)
i �� Gibson ''aG ao