HomeMy WebLinkAboutMortgage_Holden (3) . -.. i STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
di: "-F--NA FOR DEDUCTION FROM ASSESSED VALUATION
il 'i':.,t;l• State Form 43709(R13/10-15) q_s on ?• 1 Z
l'=-e= Prescribed by Department of Local Government Finance RECEIVED 1
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INSTRUCTIONS: File Mark
To be filed in person or by mail. J U N 11 2020 Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in th alendar 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)
Rodney S. Holden and Julie A. Holden, husband and wife
Taxing District .--N Key number/legal description Record number Page nu ber
Patoka 1 26-11-01-200-004.662-027 2020 2 2 0
Assessed value of real property s 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?
$194,775.00 1 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: Is the property in question:Annually Assessed
❑✓ Real Property ❑ Annually Assessed
F
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller � � ��Evansville Teachers Federal Credit Union t,,._..,
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Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715 JUN 11 2020
Name of assignee or other owner or holder of mortgage e'
_�
Address of assignee(number and street,city,state,and ZIP code) .
�
GIBSON COUNTY AUDITOR
• 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 for
in Indiana? Yes No current year? ❑
CI 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 c gCounty \ Date(month,day,year)
rn'Nitle.)e2D
II We certify under the penalty of perjury that the above and foregoing information is true correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(o -r's full name) _� Date(month,day,year)
7101 , 4,#4; h 9 1--LZ 06/03/2020
Full residen address o TVA.licant(number and street,city,state,and ZIP code)
1490 N 100 W, 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.