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„ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
Gibson 027 2020
($.7%..-4.��� �� State Form 43709(R14/1-20)� -✓ti x='=%. Prescribed byDepartment of Local Government Finance
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File Mark
INSTRUCTIONS, To be filed in person or by mail. SI Yl e — `3tio Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. m 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Kent Dunn and Lyndsi Dunn, husband and wife
Taxing District Key number/legal description Record number Pane number
Patoka 7w_s,p . 26-11-09-300-002.176-027 2-0.2-0 () i�N
•
Assessed value of real prokerty 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?
$275000.00 FYes ❑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
iF I1,..,
Real Property AnnuallylH Home
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Mobile Home 1C 6-1.1-7
Name of mortgagee or contract seller tea,.e
Evansville Teachers Federal Credit Union .
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 2 8 2020
4401 Theater Drive, Evansville, IN 47715 OCTl S1L
-Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state.and ZIP code) GIBSON COUNTY/ it01TOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction be requested If yes,state amount of deduction
other county on property for
in Indiana? ❑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 of Coun itor County G son Date(month,day,year)
w1ii�� to.2S- 201-.0
II 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 prope on date application is filed.
Signature(owner's full name) Date(month,day,year)
�+� N 10/23/2020
Full re 'dent ad.ress of applicant(number and street,city,state,and ZIP code)
493 S Old SR 65, 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.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Kent Dunn and Lyndsi Dunn Evansville Teachers Federal Credit Union
Date filed(month,day,year) Fufe70000d es�b f ` Taxing District
- Patoka
Key number/legal description
26-11-09-300-002-176-027err 2��' i L .
Signature of County 'tor/County Rj��r 2020 County Date(month,day,year)
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GIBSON COUP '
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