HomeMy WebLinkAboutMortgage_Kern (2) ,.,""".a, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
=-'- •ts FOR DEDUCTION FROM ASSESSED VALUATION 2020
are
a, - } State Form 43709(R13/10-15)
�� - File Mark
^�+, aT Prescribed by Department of Local Government Finance
INSTRUCTIONS:
To be filled 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. 0
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)
Joshua R. Kern and Chelsie L. Kern I,5-6 0
Taxing District Key number/legal description / 1025 S, Haubstadt, Indiana 47639 Record number Page number
26_kol_34-300 -oo2.1Gy-024 _ GW \330
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?
$284,240.00 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
eal Property 0 Annually Assessed
fc ILE M obile 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) AUG 4401 Theater Drive, Evansville, IN 47715 Huu 2020
Name of assignee or other owner or holder of mortgage ����-���
Address of assignee(number and street,city,state,and ZIP code) GiBso CO
LINTY AUD;T ,
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of
other county on property for deduction
in Indiana? 0 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 20 20 20 20 20
Signature o�' Auditor • County Date(month,day,year)
/We unde penalty o perjury a he above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contra b4� er of the aforementioned property on date application is filed.
411 ame ` Dat (month,day,year)
gaoP
w ) X 5 I^ 0Y0
and code 1J �l
Full resi ss of applicant(n ber and street,city,state, )
256 1025 S, 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.