HomeMy WebLinkAboutMortgage_Jorden (2) e�0, \,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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7; ._. .�<�, FOR DEDUCTION FROM ASSESSED VALUATION
•al �e�a Prescribed by Department of Local Government Finance<•2:-.)::,
'- 4 F State Form 43709(R13/10-15) Gibson Patoka Township 2020
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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)
Mark&Sonia Jorden
Taxing District Key number/legal description Record number Page nu/nbew
Patoka Township 26-12-09-300-002.525-027 2020 l 6
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the app scant the sole'
assessment date,current year assessment date,current year date of application legal or equitable owner?
$ 177,000 ❑■ 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: Is ,-pr. erty j question:Annually Assessed
41'`: 'ea lefty ❑ Annually Assessed
' Mobile Home(IC 6-1.1-7)
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Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union Car15
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Address of mortgagee or contract seller(number and street,city,state,and ZIP code) .
PSGC14 �\ O
Name of assignee or other owner or holder of mortgage Q,J
Address of assignee(number and street,city,state,and ZIP code) ..,
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction be i requestedue If yes,state amount of deduction
other county on property for
in Indiana? Yes No current year? . ❑
El 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.
Deduction approved in the amount of: 9fyvaluil,
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In .Jt�t, 020 20 20 de r�� N k(N 6 20 20
Signature of County Auditor Date(month,day,year)
.AA.,. 4,,, V qv r�� 08/26/2020
I/We certify under the penalty of perjury that the l � applicant is a resident of Indiana and
owner!contract buyer of the aforementioned prop _
Signature(owner's f name) • Date(month,day,year)
08/26/2020
Full resident address of applicant(number and street,city,state,and ZIP code)
117 S 180 E, 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.