HomeMy WebLinkAboutMortgage_Brown (8) C �a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
� -la� FOR DEDUCTION FROM ASSESSED VALUATION 2020
_,,i'JA State Form 43709(R13/10-15) File Mark
4 Prescribed by Department of Local Government Finance
eiy
INSTRUCTIONS: Form filed with:
To be filled in person or by mail.
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 County Auditor
property is located on or before January 5 of the immediately succeeding calendar year.
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the ❑ County Recorder
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)
Jarrod M. Brown and Cheryl S. Brown
Taxing District Key number/legal description 26-18-36-300-002-584-024/10047 S. Rec rd number Page number
Partridge Ave., Haubstadt, Indiana 47639 do(W) t' /.
39,
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is legal applicant
plicant the
e sole?
assessment date,current year assessment date,current year date of application 9 equitable
$403,000.00 0 Yes 0 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
0 Real Property 0 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)
'4PI
4401 Theater Drive, Evansville, IN 47715 44,-,
Name of assignee or other owner or holder of mortgage ✓/',1,
Address of assignee(number and street,city,state,and ZIP code) G/ v,V a0
Does applicant own property in any If yes,what county? What Taxing District? oHas this n propertydeduc WL'O ue ted �O Ifd yes,state amount of
other county
in Indiana? 0 Yes 0 No current year? ❑ Yes MTI'
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtednlat 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 t ek,+ uction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Sign ure of County Auditor Cou Date(month,day,year)
bs-ol� —..o — cP
I/We certify under penalty of perjury tjr4)
tbove and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contr buyer of the aforementioned property on date application is filed. Date(mfrs
day, ear)
xnature(ow is ull name) (� � ����-t4 - \/ -
dress of applicant(number and street,city,state,and ZIP co l resident pp �J
10047 S artridge Ave., Haubstadt, IN 47639
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)
Tho npnalties for oeriury can include imprisonment up to two and a half years and a fine not to exceed$10,001,