HomeMy WebLinkAboutMortgage_Douglas �¢ .,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ' CountyTownshipYear
d4/"'t'R•*% 3 FOR DEDUCTION FROM ASSESSED VALUATION
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9i '1r;''"1 State Form 43709(R13/10-15) Gibson 2020
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` '"`"" 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 ■❑ 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)
Michael M./Abby M Douglas 812-746-9883
Taxing District Key number/legal description Record number Page number
Montgomery 26-10-36-101-001.897-021 2-010 ®q y
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?
$160,000 ❑■ 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: la the property in question:Annually Assessed
■❑ Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller - -
Evansville Teacher's Federal Credit Union ,,t0 62_.0 — 0 q c.7,/ .
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) D r aw er NO
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Name of assignee or other owner or holder of mortgage
Card NO. _
Address of assignee(number and street,city,state,and ZIP code) .
Does applicant wn roperty i any If yes, at ounty? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county �/� on roe for
in Indiana Yes No �rs . I l ry7t�ler , currenPyear? ❑Yes ❑■ No
A person is no entitled to this deduction unless the person has a balanc o the pe{�n'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 courlt'y 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)
61100M,ohloft•, Gibson 06/23/2020
1/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/ ontract buye of the aforementioned property on date application is filed.
Signatur r's full Date(month,day,year)
.>
06/23/2020
ull esident a re of applicant(number and street,city,state,and ZIP code)
6757 W 40 , Owensville, In 47665 Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 1uN 2i e a�
7 2020 Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code) J 416A1117
1I /
• f OR
The penalties for perjury can include imprisonment up to two and a half yea fa north'exceed$10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Michael M./Abby M Douglas Evansville Teacher's Federal Credit Union
Date filed(month,day,year) Amount of indebtedness Taxing District
06/11/2020 $160,000.00 Montgomery
Key number/legal description
26-10-36-101-001.897-021
Signature of County Auditor/County Recorder County Date(month,day,year)
3110,0L anti.., Gibson 06/23/2020