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g�,NCounty Township Year
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
a i :° FOR DEDUCTION FROM ASSESSED VALUATION
JState Form 43709(R13/10-15) Gibson Princeton 2020
Prescribed by Department of Local Government Finance RECEIVED
rays
File Mark
INSTRUCTIONS: 'ia. I f°O 1 AUG U 6 2019 Form filed with:
To be filed in person or by mail.
Filing Dates:1)Real Property:Must be co '• ted and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarke• ith the County Auditor or County Recorder of the county where the ❑ County Recorder
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 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)
Mark F. Hinds ,
Taxing District' Key number/legal description ord number Pa u
Princeton 26-12-08-204-001.795-028 2.0
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 le I or equitable owner?
$73,700.00 160,606.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with w om
If name on record is different than that of applicant,indicate below: she 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
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) rt
4401 Theater Drive, Evansville, IN 47715 AUG 06 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and stye t,city,state,and ZIP code) :..
GIBSON COUNT/
Does applicant own property in y 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? ❑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 ,2,00 20 20 20 20
Signature of County A County y()%e)
Date,�{Jr�w%p y ea ./0I/We certify unde a penalty of perjury at the above and foregoing information is trcorrect and that the applicant i a r sident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
} Signatuyes full n e) r n ( Date(month,day,year)
\Ih3� tl/T!/I`t14-t�ytJ✓1 07/30/20
Full esideress of applicant(number and street,city,state,and ZIP code)
2201 Taylor Ave, 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 oenalties for oeriury can include imprisonment uo to two and a half years and a fine not to exceed$10,000. 45357