HomeMy WebLinkAboutMortgage_Ortiz (2) r.� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
//.._ tv,; FOR DEDUCTION FROM ASSESSED VALUATION
a =;.9f St State Form 43709(R13/10-15) oR Gibson Princeton 2020
°+ ? Prescribed by Department of Loy
sae /
INSTRUCTIONS: p/,5 File Mark
To be filed in person or by mail. /`'w Form filed with:
Filing Dates: 1) Real Property:Must be comp) - s sought.
Must be filed or postmarked w re the property is ❑ County Auditor
located on or before January! o'l �_ �j O5a ❑ County Recorder
2) Mobile/Manufactured Homes 0 LJ���JJJ editor of the county
where the property is located c e deduction is sought.
See reverse side for additional instructions ano
Applicant(owner or contract buyer-see restrictions on reverse side)
Ernesto Ortiz and Rosa Ortiz
Taxing District Key number/legal description Record number Page number
Princeton 26-12-08-402-002.613-028 2020 35Sa
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I 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?
$119,000 ❑■ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other an spouse,indicate with whom
r
t'
If name on record is different than that of applicant,indicate below: z thprope` in.. c ion:Annually Assessed
El s--,' .Apzrty�p■ nnually Assessed
4 obile Home(IC 6-1.1-7)
Name of mortgagee or contract seller 4/j6
Evansville Teachers Federal Credit Union Y 7?o20
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) /yam
Name of assignee or other owner or holder of mortgage G,R`S�N� �L j�"�ll�/
OUNT 0,
Address of assignee(number and street,city,state,and ZIP code) YAUp1r0R
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 LI No current year? ❑I
❑ 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.
I COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
. S.,,,,410 Gibson 08/17/2020
I/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/contract buyer of the aforementioned property on date application is filed.
�iature(owners f me) Date(month,day,yeah
'x\ 08/17/2020
Full resident address of applicant(number an ,state,and ZIP code)
2111 E Lake Road, 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.