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HomeMy WebLinkAboutMortgage_Lutz (4) ,.<ti�•*e�, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshi Year `'`= �a FOR DEDUCTION FROM ASSESSED VALUATION p 5 =� 1= G`,: E-> State Form 43709(R13/10-15) /' �' (,�� ©a auk. • %��' Prescribed by Department of Local Government Finance p ` _tme, INSTRUCTIONS: ark To be filed inperson ormail. ~by ��CCpp or filed with: Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is skeh 9 Must be filed or postmarked with the County Auditor or County Recorder of the county where the pr1?r 0 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 thM ty ' rof t county where the property is located during the twelve(12)months before March 31 of eab7f y nhp, t. See reverse side for additional instructions and qualifications. 0VIVT Applicant(owner or contract buyer-see restrictions on reverse side) Y AVo/7- Lutz, Andrew J. and Kaci M. R Taxing District Key number/legal description Record number Page number Haubstadt 26-19-31-304-000.406-009 ZO c),0 L6 8 g Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortga e/Contract indebtedness unpaid as of Is the applicant the sole assessment date,current year assessment date,current year date app cation co() legal or equitable owner? 166800 Lv Ib�00 El Yes El No If no,what is his/her exact share of interest? If owned with s meone her than spouse,indicate with whom If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed I] Real Property ❑ 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) 4401 Theater Dr., Evansville, IN 47715 _ Name of assignee or other owner or holder of mortgage 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 been requested If yes,state amount of deduction other county on property for in Indiana? Yes No current year? ❑❑ III 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 n Audito[ ...,if / County \C�� Date(mont,day,yea �n ^ / l� ck 2� W 1/We certify under the penalty of perjury that the above and foregoing information is true correct and that the applicant is a resident f Indiana and owner/contract buyer of the forementio ed property on date application is filed4 n rite yvners full name) ,1r (/ Date(month,day,year) , ' �,1 09/23/2020 Full'resident ddress of appli (nit-r... et,. et,ci r ty,state,and ZIP code) 206 S. First St., Haubstad , N 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 oeriury can include imprisonment up to two and a half years and a fine not to exceed$10.000.