HomeMy WebLinkAboutMortgage_Asher p7,,E:�„ � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship
/,,;�,�: Year
,' a FOR DEDUCTION FROM ASSESSED VALUATION
hT , f. , State Form 43709(R14/1-20) Gibson Johnson 2020
z e;ifii d' Prescribed by Department o Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. E County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is
located on or before January 5 of the calendar year in which the property taxes are first due and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
'Applicant(owner or contract buyer-see restrictions on reverse side)
Alden,Asher C/Brittany L
Taxing District Key number/legal description Record number Page number
Johnson 26-18-36-300-002.027-024 Za2.3 L16111 •
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. e• itable owner?
►1Yes ❑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
®Real Property ❑Annually Assessed
•ei.e Home(IC 6-1.1-7)
Name of mortgagee or contract seller • A Illp
Evansville Teachers Federal Credit Union ...vlit * I
Address of mortgagee or contract seller(ni - -'-'- --'"'U--J^' as .
fO �� I/ 2020
OName of assignee or other owner or holder c,I 1 4
Address of assignee(number and street,c Drawer N O / A /
Does applicant own property in ny If yE T duction been requested Yt et 3 amount of deduction
other county Card O• t for Q �'
in Indiana? ❑Yes No tr? El Yes d
A person is not entitled o this deductic .._ ,,,.,,.y..ya 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
Signet e f County Auditor
c County Date(month,day,year)
ke Gibson 10/14/2020
4vve certify under nalty of perjury th above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforemention perty on date application is filed.
Signatu (o ner's fir n me) Date(month,day,year)
10/14/2020
Full resident addres of (number and street,city,state.and ZIP code)
10183 S Quail Crossing, 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.